首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (2): 289-293.doi: 10.3969/j.issn.1006-7795.2022.02.021

• 临床研究 • 上一篇    下一篇

埃克替尼联合抗血管药物一线治疗EGFR突变晚期肺腺癌的单中心研究

姚舒洋1, 李小雪1, 王淳秀2, 张毅1*   

  1. 1.首都医科大学宣武医院胸科, 北京 100053;
    2.首都医科大学宣武医院循证医学中心, 北京 100053
  • 收稿日期:2021-06-10 出版日期:2022-04-21 发布日期:2022-04-14
  • 基金资助:
    2019年吴阶平医学基金(19088-18)。

Icotinib plus antiangiogenic agent as the first-line treatment for advanced EGFR mutant lung adenocarcinoma: a single-center study

Yao Shuyang1, Li Xiaoxue1, Wang Chunxiu2, Zhang Yi1*   

  1. 1. Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China;
    2. Department of Evidence-based Medicine, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
  • Received:2021-06-10 Online:2022-04-21 Published:2022-04-14
  • Contact: *E-mail:steven9130@126.com
  • Supported by:
    2019 Wu Jieping Medical Foundation (19088-18).

摘要: 目的 观察埃克替尼联合抗血管药物一线治疗表皮生长因子受体(epidermal growth factor receptor,EGFR)突变晚期肺腺癌的治疗效果和不良反应。方法 选取首都医科大学宣武医院胸科2018年6月1日至2019年12月31日期间,37例EGFR突变晚期肺腺癌的患者。采用埃克替尼(125 mg/次,3 次/d)联合贝伐单抗(7.5 mg/kg,1次/3周);或埃克替尼(125 mg/次,3 次/d)联合安罗替尼(10~12 mg 1次/d,第1~14天),均21 d为1个周期,至疾病进展或出现严重的不良反应后终止。中位随访时间14.5(9.2~30.8)个月。结果 本组患者中,62.2%(23/37)达到部分缓解,37.8% (14/37) 达到疾病稳定。客观有效率为62.2%(23/37),疾病控制率为100%(37/37)。中位疾病无进展时间为17.9个月(95% CI:10.292~25.508)个月。1年生存率为83.8%,18个月生存率为81.1%。多因素Cox回归分析结果显示,肝转移和脑转移对患者的PFS有明显影响(P<0.05)。最常见不良反应为皮疹(43.2%, 16/37)和腹泻(21.6%, 8/37)。结论 埃克替尼联合抗血管药物是一种有效且安全的一线治疗EGFR突变晚期肺腺癌的方案。

关键词: 肺腺癌, 表皮生长因子受体基因突变, 靶向治疗, 抗血管治疗

Abstract: Objective To assess the efficacy and safety of icotinib plus antiangiogenic agent for epidermal growth factor receptor (EGFR) mutation non-small cell lung cancer (NSCLC). Methods From June 1, 2018 to December 31, 2019, in the Department of Thoracic Surgery of Xuanwu Hospital, Capital Medical University, we summarized the experience with icotinib plus antiangiogenic agent as the first-line treatment in 37 patients with advanced EGFR mutant lung adenocarcinoma. The patients received icotinib (125 mg, three times per day) combined with bevacizumab (7.5 mg/kg, every three weeks) or icotinib (125 mg, three times per day) combined with anlotinib (10-12 mg, daily, day 1-14) until disease progression or unacceptable toxicity. Each regimen was 21-day per cycle. The median follow-up was 14.5(9.2-30.8)months. Results In this study, 62.2%(23/37) achieved partial remissions and 37.8% (14/37) achieved stable diseases. The objective response rate was 62.2%(23/37) and disease control rate was 100%. The median progression-free survival was 17.9(95%CI:10.292-25.508)months.One-year overall survival (OS) rate was 83.8% and 18-month OS 81.1%.According to multivariate analysis, patients with liver metastasis or brain metastasis had significantly worse prognosis (P<0.05). Rash (43.2%, 16/37)and diarrhea(21.6%, 8/37) were predominant adverse events. Conclusion The combination of icotinib and antiangiogenic agent appears to be an efficient and well-tolerated regimen as first-line treatment for advanced EGFR mutant lung adenocarcinoma patients.

Key words: lung adenocarcinoma, epidermal growth factor receptor mutation, targeted therapy, antiangiogenic agent

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