国际肿瘤学杂志

国际肿瘤学杂志 ›› 2017, Vol. 44 ›› Issue (1): 19-23.doi: 10.3760/cma.j.issn.1673422X.2017.01.005

• 论著 • 上一篇    下一篇

EGFR-TKI一线治疗不同EGFR突变状态晚期非小细胞肺癌疗效分析

姜海英,李艳芳,朱梅,李倩,吕姣   

  1. 221005 徐州市肿瘤医院肿瘤内科
  • 出版日期:2017-01-08 发布日期:2016-12-07
  • 通讯作者: 姜海英，Email: jianghaiyinghu@sina.com E-mail:jianghaiyinghu@sina.com
  • 基金资助:

    国家十二五科技支撑计划（2013BAI06B04H008）

Association between EGFR mutation status and efficacy of first-line EGFR-TKI in patients with advanced non-small cell lung cancer

Jiang Haiying, Li Yanfang, Zhu Mei, Li Qian, Lyu Jiao   

  1. Department of Oncology, Xuzhou Cancer Hospital, Xuzhou 221005, China
  • Online:2017-01-08 Published:2016-12-07
  • Contact: Jiang Haiying, Email: jianghaiyinghu@sina.com E-mail:jianghaiyinghu@sina.com
  • Supported by:

    National Science & Technology Support Plan during the 12th Five-Year Plan Period (2013BAI06B04H008)

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1338

被引次数

7

摘要： 目的  分析表皮生长因子受体酪氨酸酶抑制剂（EGFR-TKI）一线治疗不同EGFR突变状态（外显子19缺失、21突变）晚期非小细胞肺癌（NSCLC）的疗效。方法  收集徐州市肿瘤医院经组织病理学证实的EGFR突变阳性晚期NSCLC患者72例，分析两种不同EGFR突变状态与一线EGFRTKI治疗的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）以及总生存期（OS）之间的关系。结果  72例患者均进行EGFR基因检测，其中37例为EGFR19外显子缺失，35例为EGFR21外显子突变。72例患者均可评价疗效，其中EGFR19外显子缺失的患者ORR 75.7%，DCR 89.2%；EGFR21外显子突变的患者ORR 51.4%，DCR 68.6%，差异均有统计学意义（χ2=4.583，P=0.032；χ2=4.636，P=0.031）。EGFR19外显子缺失和21外显子突变的患者校正后的中位PFS分别为13.2个月、10.8个月，差异有统计学意义（χ2=4.700，P=0.030）；中位OS分别为30.2个月、25.6个月，差异有统计学意义（χ2=4.686，P=0.030）。两组间不良反应无明显差别，皮疹最为常见，两组差异无统计学意义（48.7%∶48.6%，χ2=0.000，P=0.995）。结论  EGFR突变状态是晚期NSCLC患者一线EGFR-TKI治疗疗效和OS的预测因素，EGFR19外显子缺失患者的疗效优于EGFR21外显子突变患者。

关键词: 受体, 表皮生长因子, 癌, 非小细胞肺, 表皮生长因子受体酪氨酸酶抑制剂

Abstract: Objective  To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) on advanced non-small cell lung cancer (NSCLC) patients with different EGFR mutation status (exon 19 deletion and exon 21 mutation). Methods  Seventytwo advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled. All of the patients received firstline EGFRTKI. The relationships between EGFR mutation status and objective response rate (ORR), disease control rate (DCR), progression free survival (PFS) and overall survival (OS) were analyzed. Results  Of the 72 patients, 37 patients expressed exon 19 deletion, 35 patients expressed exon 21 mutation, and all of them could be evaluated. The ORR and DCR of patients with exon 19 deletion were higher than those of patients with exon 21 mutation (75.7% vs. 51.4%, χ2=4.583, P=0.032; 89.2% vs. 68.6%, χ2=4.636, P=0.031). The modified median PFS of patients with exon 19 deletion was significantly higher than that of patients with exon 21 mutation (13.2 month vs. 10.8 month, χ2=4.700, P=0.030). The median OS of patients with exon 19 deletion was significantly higher than that of patients with exon 21 mutation (30.2 month vs. 25.6 month, χ2=4.686, P=0.030). The side effects were similar between the two groups. The most common adverse reaction was rash, and the incidence had no significant difference between the two groups (48.7% vs. 48.6%, χ2=0.000, P=0.995). Conclusion   EGFR mutation status is a predictor for PFS, OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC. NSCLC patients with EGFR exon 19 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

Key words: Receptor, epidermal growth factor, Carcinoma, non-small-cell lung, EGFR-TKI