| 于晓露,王慧敏,王韡旻.埃克替尼一线治疗134例EGFR突变阳性的晚期肺腺癌的疗效分析[J].肿瘤学杂志,2017,23(9):772-775. |
| 埃克替尼一线治疗134例EGFR突变阳性的晚期肺腺癌的疗效分析 |
| Efficacy of Icotinib as First-Line Therapy for 134 Patients with Advanced Lung Adenocarcinoma of Positive EGFR Mutation |
| 投稿时间：2017-05-01 |
| DOI：10.11735/j.issn.1671-170X.2017.09.B006 |
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| 中文关键词: 埃克替尼 腺癌 一线治疗 疗效 |
| 英文关键词:icotinib adenocarcinoma first-line therapy efficacy |
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| 中文摘要: |
| 摘 要：［目的］ 观察埃克替尼一线治疗EGFR突变阳性的晚期肺腺癌患者的疗效及不良反应。［方法］ 对134例Ⅲb/Ⅳ期EGFR突变阳性的晚期肺腺癌患者应用埃克替尼125mg 每天三次治疗，直至疾病进展或出现不可耐受的不良反应。［结果］ 134例EGFR基因突变阳性晚期肺腺癌患者中，完全缓解(CR)6例（4.5%），部分缓解(PR)90例（67.2%），疾病稳定（SD）32例（23.9%），疾病进展（PD）6例（4.5%)。客观缓解率（ORR)为71.6%(96/134)，疾病控制率(DCR)为95.5%（128/134）。中位无进展时间（mPFS）为11.2个月(95%CI：9.8～12.5个月），OS尚未获得。19外显子缺失突变的ORR 为81.8%，DCR为93.5%，mPFS为11.8个月。21外显子L858R突变患者ORR 为 57.9%，DCR为94.7%，mPFS为10.2个月。19外显子缺失突变的ORR明显优于21外显子L858R突变（81.8% vs 57.9%，P=0.002)。不吸烟患者的ORR优于吸烟患者（77.4% vs 58.5%，P=0.025)。不同性别、年龄、肺癌分期、EGFR突变类型、吸烟状态对mPFS和DCR的影响无统计学差异。主要不良反应为Ⅰ～Ⅱ度的皮疹（44.8%）和腹泻（25.3%），经对症处理后，患者多可耐受。［结论］ 埃克替尼一线治疗EGFR突变阳性的晚期肺腺癌患者取得了很好的疗效，不良反应的发生率低，且患者多可耐受。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the efficacy and adverse effect of icotinib as first-line therapy in treatment of patients with EGFR-mutation positive advanced lung adenocarcinoma. ［Methods］ One hundred and thirty four patients with EGFR-mutation positive advanced lung adenocarcinoma received oral icotinib(125mg，tid) as first-line therapy until disease progression or intolerable toxicity appeared. ［Results］ Among 134 patients，complete response(CR) was achieved in 6 cases(4.5%)，partial response(PR) in 90 cases(67.2%)，stable disease(SD) in 32 cases（23.9%） and progressive disease(PD) in 6 cases(4.5%). The ORR was 71.6%(96/134)，DCR was 95.5%（128/134），mPFS was 11.2 months(95%CI：9.8～12.5months)，and OS was not obtained yet. The ORR，DCR and mPFS of 19 exon muntation positive patients were 81.8%，93.5%，11.8months，respectively. The ORR，DCR and mPFS of 21 exon muntation positive patients were 57.9%，94.7%，10.2months，respectively. Patients with 19 exon mutation showed better ORR than those with 21 L858R mutation(81.8% vs 57.9%，P=0.002). Non-smoking patients showed better ORR than smokers(77.4% vs 58.5%，P=0.025). There were no significant differences in mPFS and DCR among patients of different gender，age，clinical stage，EGFR mutation state and smoking state. The main adverse effects wereⅠ～Ⅱ degrees of rash(44.8%) and diarrhea(25.3%)，which were generally tolerated after symptomatic treatment. ［Conclusion］ The results suggest that icotinib is effective for patients with EGFR-mutation positive advanced lung adenocarcinoma as first-line therapy with low and tolerated adverse effects. |
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