培美曲塞单药或联合吉非替尼治疗EGFR-TKI耐药后晚期非小细胞肺癌临床观察

发布时间：2018-05-19 13:01

本文选题：培美曲塞 + 吉非替尼　；参考：《中国癌症杂志》2017年02期

【摘要】：背景与目的:生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)治疗晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)获得性耐药后尚无标准的治疗方案,亟待探寻有效的后续治疗方法。为临床应用提供指导,该研究旨在比较后续治疗采用培美曲塞单药或联合吉非替尼治疗EGFR-TKI获得性耐药的晚期NSCLC的临床疗效及安全性。方法:入组既往接受过EGFR-TKI治疗后进展的晚期NSCLC患者62例。其中32接受培美曲塞联合吉非替尼治疗,设为联合组;30例单用培美曲塞治疗,设为化疗组。评价临床疗效及不良反应。结果:联合组客观有效率(objective response rate,ORR)为46.9%,高于化疗组的20%,差异有统计学意义(χ2=4.933,P0.05);两组疾病控制率(disease control rate,DCR)差异无统计学意义(P0.05);联合组的中位无病生存期(progression-free survival,PFS)为8.0个月,化疗组中位PFS为6.3个月,差异有统计学意义(χ2=8.063,P0.05),两组总生存期(overall survival,OS)差异无统计学意义(P0.05)。联合组中性粒细胞减少、皮疹的发生率高于化疗组,差异有统计学意义(P0.05),Ⅲ~Ⅳ不良反应两组差异无统计学意义(P0.05)。结论:晚期NSCLC患者EGFR-TKI获得性耐药后,采用培美曲塞联合吉非替尼较单用培美曲塞显示出更优势临床有效率和中位PFS,不良反应可耐受,值得临床推广运用。
[Abstract]:Background & AIM: there is no standard treatment for advanced non-small cell lung cancer with EGFR-TKI-based growth factor receptor-tyrosine kinase inhibitor EGFR-TKI. To provide guidance for clinical application, this study was designed to compare the efficacy and safety of pemetrexide alone or gefitinib in the treatment of advanced NSCLC with acquired resistance to EGFR-TKI. Methods: 62 patients with advanced NSCLC who had been treated with EGFR-TKI. 32 of them were treated with pemetrexil combined with gefitinib, 30 patients were treated with pemetrexil alone and treated as chemotherapy group. To evaluate the clinical efficacy and adverse reactions. Results: the objective effective rate of the combined group was 46.9, which was higher than that of the chemotherapy group (20%), the difference was statistically significant (蠂 2, 4.933, P 0.05), the disease control rate of the two groups was not significantly different from that of the control rate of control, and the median disease-free survival rate of the combined group was 8.0 months. The median PFS of chemotherapy group was 6.3 months, the difference was statistically significant (蠂 ~ 2 = 8.063, P 0.05). There was no significant difference in total survival time between two groups (P 0.05). The incidence of neutropenia and rash in the combined group was higher than that in the chemotherapy group, and the difference was statistically significant (P 0.05), but there was no significant difference in the adverse reactions between the three groups (P 0.05). Conclusion: after acquired drug resistance of EGFR-TKI in patients with advanced NSCLC, pemetrexide combined with gefitinib is more effective than that of pemetrexil alone, and the adverse reaction is tolerable, which is worth popularizing.
【作者单位】：郑州大学第二附属医院肿瘤科;
【分类号】：R734.2

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