达可替尼在真实世界中治疗EGFR突变阳性晚期非小细胞肺癌患者的临床疗效和安全性  

Clinical efficacy and safety of dacomitinib in treating the patients with advanced non-small cell lung cancer harbouring positive EGFR mutation in real world

作　　者：施玥 姜莹莹 季敏 薛婧婧 莫蕾 朱梦霞 薛梦鑫 田海霞 王晓华[1] 陈诚[2] 冯继锋[1] SHI Yue;JIANG Yingying;JI Min(Department of Oncology,Affiliated Cancer Hospital,Nanjing Medical University,Nanjing 210009,CHINA)

机构地区：[1]南京医科大学附属肿瘤医院(江苏省肿瘤医院,江苏省肿瘤防治所)肿瘤内科,江苏210009 [2]南京医科大学附属肿瘤医院(江苏省肿瘤医院,江苏省肿瘤防治所)放射治疗科,江苏210009 [3]南京医科大学

出　　处：《江苏医药》2021年第1期52-57,共6页Jiangsu Medical Journal

摘　　要：目的探讨达可替尼在表皮生长因子受体(EGFR)突变阳性晚期非小细胞肺癌(NSCLC)患者的治疗效果及安全性。方法回顾性分析50例EGFR突变阳性晚期NSCLC患者的临床资料,其中的24例(A组)给予达可替尼治疗,26例(B组)给予第一代表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗。比较两组患者临床结局和不良反应发生情况。结果A组患者的中位无进展生存期(PFS)为6.0个月,中位总生存期(OS)为11.0个月;患者的性别、年龄、有无吸烟史和基因突变类型对中位PFS和OS均无显著影响(P>0.05),但一线使用达可替尼的患者比二线使用达可替尼的患者拥有更长的中位PFS(P<0.05)。与B组比较,A组EGFR 21外显子突变阳性患者服用达可替尼作为一线治疗能延长PFS(P<0.05)。服用达可替尼后的不良反应主要包括甲沟炎、皮疹、食欲不振和腹泻,21例患者因轻度不良反应而下调达可替尼剂量。结论与EGFR-TKI比较,达可替尼治疗EGFR突变阳性晚期NSCLC患者的临床效果较好,且患者耐受性较高。Objective To investigate the clinical efficacy and safety of dacomitinib in the treatment of the patients with advanced non-small cell lung cancer(NSCLC)harbouring positive epidermal growth factor receptor(EGFR)mutation.Methods The clinical data of 50 patients with advanced NSCLC harbouring positive EGFR mutation were retrospectively analyzed,of whom 24 cases(group A)were treated with dacomitinib and 26 cases(group B)were treated with first-generation epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI).The clinical outcomes and adverse responses were compared between the two groups.Results The median progression-free survival(PFS)and overall survival of the patients in group A were 6.0 months and 11.0 months,respectively.The sex,age,smoking history and type of gene mutation had no significant effect on the median PFS and OS(P>0.05).The median PFS was longer in the patients of group A taking dacomitinib as a first-line treatment than those of group A taking dacomitinib as a second-line treatment(P<0.05).Compared with the patients of group B,taking dacomitinib as a first-line treatment could prolong PFS in the patients of group A(P<0.05).The adverse responses of group A included paronychia,rash,anorexia and diarrhea,of whom 21 cases had a dose reduction of dacomitinib due to mild adverse responses.Conclusion Compared to EGFR-TKI,clinical efficacy of dacomitinib is better and the tolerance is higher in the treatment of the patients with advanced NSCLC harbouring positive EGFR mutation.

关 键 词：非小细胞肺癌 达可替尼 表皮生长因子受体酪氨酸激酶抑制剂 靶向治疗 

分 类 号：R734[医药卫生—肿瘤]