CYP3A4基因18B位点多态性与晚期EGFR基因突变NSCLC患者疗效及不良反应的关系

发布时间：2018-01-21 00:34

本文关键词： 非小细胞肺癌细胞色素A 表皮生长因子基因多态性酪氨酸激酶抑制剂治疗结果不良反应　出处：《山东医药》2017年37期 　论文类型：期刊论文

【摘要】：目的探讨细胞色素3A4(CYP3A4)基因18B位点(CYP3A4*18B)多态性与表皮生长因子受体(EGFR)基因突变晚期非小细胞肺癌(NSCLC)患者疗效及不良反应的关系。方法选择EGFR基因突变晚期初治NSCLC患者44例,口服EGFR酪氨酸激酶抑制剂(EGFR-TKI)吉非替尼片250 mg,1次/d;或厄洛替尼片150 mg,1次/d。直至患者病情进展或无法耐受不良反应而停药。治疗前采用PCR及直接测序法检测CYP3A4*18B的基因突变状态,比较突变型和野生型患者疗效(客观缓解率、疾病控制率)及不良反应的差异。结果 CYP3A4*18B基因突变频率为36.4%(16/44),野生型纯合子占63.6%(28/44),突变型杂合子占34.1%(15/44),突变型纯合子占2.3%(1/44)。野生型与突变型患者疗效比较差异无统计学意义(P均0.05),野生型患者皮疹发生率高于突变型患者(P0.05)。结论 CYP3A4*18B的多态性与晚期EGFR基因突变NSCLC患者的EGFR-TKI疗效无关,与药物不良反应有关。
[Abstract]:Objective to investigate the relationship between cytochrome 3A4 (CYP3A4) gene 18B polymorphism and epidermal growth factor receptor (EGFR) gene mutation in advanced non-small cell lung cancer (NSCLC). Methods 44 patients with EGFR gene mutation in late stage of NSCLC were selected. Oral administration of EGFR tyrosine kinase inhibitor, EGFR-TKI, was performed at a dose of 250 mg / d. Or erlotinib 150mg. Before treatment, PCR and direct sequencing were used to detect the mutation status of CYP3A4*18B gene. The efficacy (objective remission rate, disease control rate) and adverse reaction (ADR) of mutant and wild type patients were compared. Results the mutation frequency of CYP3A4*18B gene was 36. 4% / 44). Wild type homozygote accounted for 63.6% and mutant heterozygote accounted for 34.1% of 44%. Mutant homozygote accounted for 2. 3 / 44. There was no significant difference between wild type and mutant type (P 0. 05). The incidence of rash in wild-type patients was higher than that in mutant patients (P0.05). Conclusion Polymorphism of CYP3A4*18B is not associated with the efficacy of EGFR-TKI in patients with advanced EGFR gene mutation NSCLC. Related to adverse drug reactions.
【作者单位】：石河子大学医学院第一附属医院;
【基金】：国家自然科学基金资助项目(81560381) 吴阶平研究课题资助项目(320.6750.14269)
【分类号】：R734.2
【正文快照】： 非小细胞肺癌(NSCLC)占所有组织类型肺癌的85%[1]。随着对肿瘤发生机制研究的不断深入, 对不同组织类型的肺癌可行进一步的分子分型。表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)是治疗NSCLC的一线药物,患者总生存时间2~24个月[2],个体差异显著。目前对EGFR-TKI疗效的判断主

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