安罗替尼治疗二线化疗失败的晚期非小细胞肺癌的疗效观察  

Efficacy of anlotinib in the treatment of advanced non-small cell lung cancer with failed second-line chemotherapy

作　　者：高红杰 代珊珊 杨欢 GAO Hongjie;DAI Shanshan;YANG Huan(Department of Pharmacy,Civil Aviation General Hospital,Beijing 100123,China)

机构地区：[1]民航总医院药剂科,北京1001230

出　　处：《癌症进展》2020年第10期1023-1026,1068,共5页Oncology Progress

摘　　要：目的观察安罗替尼治疗二线化疗失败的晚期非小细胞肺癌(NSCLC)的临床疗效。方法 49例晚期NSCLC患者予以盐酸安罗替尼口服,治疗2个周期后观察基质金属蛋白酶2(MMP2)、肿瘤坏死因子-β1(TNF-β1)、金属肽酶组织抑制剂-1(TIMP-1)、血管内皮生长因子(VEGF)水平,按照实体瘤疗效评价标准评价疗效,评价不良反应发生情况,随后评价无进展生存期(PFS)和总生存期(OS)。结果入组49例患者均可进行疗效评价,其中未见完全缓解(CR),部分缓解(PR)占6.12%(3/49),疾病稳定(SD)占59.18%(29/49),疾病进展(PD)占34.69%(17/49),客观缓解率(ORR)、疾病控制率(DCR)分别为6.12%、65.31%。服药期间所出现的不良反应主要为1~2级,3~4级较少,患者耐受良好,且以高血压、疲劳、促甲状腺激素升高、蛋白尿、手足综合征、口腔黏膜炎等多见,对症处理后好转。治疗2个周期后晚期NSCLC患者TIMP-1、VEGF、MMP2、TNF-β1水平均较治疗前明显下降,差异均有统计学意义(P﹤0.01)。47例晚期NSCLC患者随访时间3~17个月,中位随访时间11.20个月,中位PFS为3.49个月(95%CI:2.74~4.57),中位OS为8.87个月(95%CI:6.95~10.49)。结论在二线化疗方案失败后,给予盐酸安罗替尼治疗晚期NSCLC的疗效显著,在一定程度上可抑制肿瘤的增殖及浸润,不良反应总体可控。Objective To observe the clinical efficacy of anlotinib in the treatment of advanced non-small cell lung cancer(NSCLC)with failed second-line chemotherapy.Method Two cycles of oral anlotinib hydrochloride were administered for 49 cases with advanced NSCLC,and the levels of matrix metalloproteinase 2(MMP2),tumor necrosis factor-β1(TNF-β1),TIMP metallopeptidase inhibitor 1(TIMP-1),and vascular endothelial growth factor(VEGF)were detected in these patients;besides,response evaluation criteria in solid tumor(RECIST)was followed to assess the efficacy and incidence of adverse reactions,additionally,progression-free survival(PFS)and overall survival(OS)were subsequently evaluated.Result All the 49 patients were evaluable for efficacy,while no complete response(CR)was observed,and partial response(PR)was noted in 6.12%(3/49),stable disease(SD)in 59.18%(29/49),and progressive disease(PD)in 34.69%(17/49),with overall response rate(ORR)and disease control rate(DCR)being 6.12%and 65.31%,respectively.Adverse reactions during taking medication were mainly grade 1-2,though adverse reactions of grade 3-4 were rare,the regimen was well tolerated in these patients,and the commonest symptoms included hypertension,fatigue,elevated thyroid-stimulating hormone,proteinuria,hand-foot syndrome,oral mucositis,etc.,and all were resolved after symptomatic treatment.After 2 cycles of treatment,the TIMP-1,VEGF,MMP2,and TNF-β1 levels in both groups decreased significantly,with significant differences observed between the groups(P<0.01).The follow-up perioed for 47 patients with advanced NSCLC was 3-17 months,and the median follow-up time was 11.20 months,revealing a median PFS of 3.49 months(95%CI:2.74-4.57)and a median OS of 8.87 months(95%CI:6.95-10.49),respectively.Conclusion After the failure of second-line chemotherapy,the administration of anlotinib hydrochloride demonstrates significant efficacy in the treatment of advanced NSCLC,inhibiting the tumor proliferation and infiltration,with generally controllable adverse reactions.

关 键 词：安罗替尼 晚期非小细胞肺癌 临床疗效 

分 类 号：R735.3[医药卫生—肿瘤]