帕博西尼治疗晚期Kristen鼠肉瘤致癌基因突变型非小细胞肺癌的疗效  

Efficacy of palbociclib in the treatment of advanced non-small cell lung cancer with Kirsten rat sarcoma viral oncogene mutant action

作　　者：郑泉 李传香 郭红荣 ZHENG Quan;LI Chuanxiang;GUO Hongrong(Department of Respiratory and Critical Care,Optic Valley District of Wuhan Third Hospital,Wuhan 430060,China)

机构地区：[1]武汉市第三医院光谷院区呼吸与危重症医学科,武汉430060

出　　处：《西北药学杂志》2023年第6期158-162,共5页Northwest Pharmaceutical Journal

基　　金：武汉市医学科研项目(编号:WX21Q56)。

摘　　要：目的探讨用细胞周期蛋白依赖性激酶(cyclin-dependent kinases,CDKs)抑制剂帕博西尼治疗Kristen鼠肉瘤致癌基因(Kirsten rat sarcoma viral oncogene,KRAS)突变型晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及安全性。方法选取80例KRAS突变型NSCLC患者,用随机数字表法分为2组,每组40例。对照组用GP化疗方案治疗,研究组在对照组治疗的基础上用CDK抑制剂帕博西尼治疗。比较2组患者的近期临床疗效、治疗前后的卡氏评分(Karnofsky,KPS)、肿瘤标志物[癌胚抗原(carcinoembryonic antigen,CEA)、细胞角质蛋白19片段抗原21-1(cyto-keratin 19 fragment antigen 21-1,CYFRA21-1)]水平、不良反应发生情况及生存时间。结果治疗后,研究组的客观缓解率为47.50%、疾病控制率为75.00%,均高于对照组(P<0.05);治疗后,2组的KPS与CEA、CYFRA水平均改善,且研究组[(79.95±7.02)分、(15.94±2.01)μg·L^(-1)、(5.74±1.55)mm·h^(-1)]均优于对照组(P<0.05);研究组的无进展生存期[(8.96±1.58)个月]、总生存期[(19.86±2.94)个月]均长于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论用CDK抑制剂治疗KRAS突变型非小细胞肺癌的临床效果显著,能延长患者的生存时间,提高患者的生活质量,且未增加不良反应的发生率。Objective To investigate the clinical efficacy and safety of palbociclib,an inhibitor of cyclin-dependent kinases(CDKs),in the treatment of non-small cell lung cancer(NSCLC)with mutant action of Kirsten rat sarcoma viral oncogene(KRAS).Methods Eighty patients with KRAS mutant NSCLC were randomly divided into 2 groups,40 patients in each group.The control group was treated with GP chemotherapy,and the research group was treated with palbociclib,a CDK inhibitor,on the basis of the control group.The short-term clinical efficacy,KPS,tumor markers[carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)]levels,adverse reactions and survival time were compared between the 2groups.Results The recent objective remission rate 47.50%and disease control rate 75.00%in research group were higher than those in control group 25.00%,and 52.50%(P<0.05).After treatment,the levels of KPS,CEA and CYFRA in the 2groups improved,and the research group[(79.95±7.02)score,(15.94±2.01)μg·L^(-1),(5.74±1.55)mm·h-1]were better than the control group(P<0.05).The progression free survival period[(8.96±1.58)mouthes]and total survival period[(19.86±2.94)mouthes]in research group were longer than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2groups(P>0.05).Conclusion The clinical effect of CDK inhibitor in the treatment of KRAS mutant non-small cell lung cancer is remarkable,which can prolong the survival time and improve the quality of life of patients without increasing the incidence of adverse reactions.

关 键 词：帕博西尼 晚期非小细胞肺癌(NSCLC) KRAS基因突变 肿瘤标志物 

分 类 号：R979.1[医药卫生—药品]