吉非替尼联合培美曲塞治疗表皮生长因子受体-酪氨酸激酶抑制剂获得性耐药晚期肺腺癌的疗效观察  

Clinical efficacy of gefitinib combined with pemetrexed in the treatment of advanced lung adenocarcinoma with acquired drug resistance to epidermal growth factor receptor-tyrosine kinase inhibitor

作　　者：王辉[1] 刘宽[1] 杨叶叶 WANG Hui;LIU Kuan;YANG Yeye(Department of Respiratory and Critical Care Medicine,Sanmenxia Central Hospital,Sanmenxia 472000,He’nan,China)

机构地区：[1]三门峡市中心医院呼吸与危重症医学科,河南三门峡4720000

出　　处：《癌症进展》2020年第20期2102-2105,共4页Oncology Progress

摘　　要：目的探讨吉非替尼联合培美曲塞治疗表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)获得性耐药晚期肺腺癌的临床疗效及不良反应。方法根据EGFR-TKI治疗耐药后用药方案的不同,将85例EGFR-TKI获得性耐药晚期肺腺癌患者分为观察组(n=45)和对照组(n=40),对照组患者采用培美曲塞治疗,观察组患者采用吉非替尼联合培美曲塞治疗。比较两组患者治疗后的客观有效率(ORR)、治疗前后的血清学指标[癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]、无进展生存情况和治疗期间的不良反应。结果观察组患者的ORR为46.67%(21/45),高于对照组的22.50%(9/40),差异有统计学意义(P<0.05)。治疗后,两组患者的血清CEA、NSE和CYFRA21-1水平均低于本组治疗前,且观察组患者的血清CEA、NSE和CYFRA21-1水平均低于对照组,差异均有统计学意义(P<0.05)。治疗期间,两组患者白细胞减少、血小板减少、胃肠道反应、谷丙转氨酶升高的发生率比较,差异均无统计学意义(P>0.05)。观察组患者的中位无进展生存期(PFS)为7.9个月,对照组患者的中位PFS为5.4个月。观察组患者的无进展生存情况优于对照组,差异有统计学意义(P<0.05)。结论吉非替尼联合培美曲塞治疗EGFR-TKI获得性耐药晚期肺腺癌可降低相关肿瘤标志物水平,不良反应在可控范围内,并且可延长患者的PFS,疗效较好。Objective To investigate the clinical efficacy and adverse reaction of gefitinib combined with pemetrexed in the treatment of advanced lung adenocarcinoma with acquired drug resistance to epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI).Method According to the different drug regimens after EGFR-TKI therapy,85 advanced lung adenocarcinoma patients with EGFR-TKI acquired drug resistance were divided into observation group(n=45)and control group(n=40).Patients in the control group were treated with pemetrexed,while patients in the observation group were treated with gefitinib combined with pemetrexed.Objective response rate(ORR),serological indicators[carcinoembryonic antigen(CEA),neuron specific enolase(NSE),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)],progression-free survival(PFS)and adverse reactions were compared between the two groups.Result The ORR of the observation group was 46.67%(21/45),which was higher than 22.50%(9/40)of the control group(P<0.05).After treatment,the serum CEA,NSE and CYFRA21-1 levels of the two groups were lower than those before treatment,and the serum CEA,NSE and CYFRA21-1 levels of the observation group were statistically lower than those of the control group(P<0.05).During the treatment,there was no significant difference in the incidence of leukopenia,thrombocytopenia,gastrointestinal reaction,and elevated alanine aminotransferase between the two groups(P>0.05).The median PFS was 7.9 months in the observation group and 5.4 months in the control group.The PFS of the observation group was better than that of the control group(P<0.05).Conclusion In treatment of advanced lung adenocarcinoma patients with EGFR-TKI acquired drug resistance,gefitinib combined with pemetrexed can significantly reduce the level of related tumor markers,prolong the median PFS,and the adverse reactions are under control.

关 键 词：吉非替尼 表皮生长因子受体-酪氨酸激酶抑制剂 培美曲塞 肺腺癌 

分 类 号：R734.2[医药卫生—肿瘤]