文章摘要

奥希替尼治疗T790M突变的晚期肺腺癌1例并文献复习

作者: 1吴 锋杰, 1顾 阳阳, 1姚 扬伟
1 嘉兴市第二医院呼吸与危重症医学科,浙江 嘉兴 314000
通讯: 顾 阳阳 Email: guyywaitforu@163.com
DOI: 10.3978/j.issn.2095-6959.2020.01.040
基金: 嘉兴市科技计划(2017AY33029)。

摘要

在肺癌的驱动基因中,表皮生长因子(epidermal growth factor receptor,EGFR)是其最常见的驱动基因之一。在EGFR突变阳性的患者中,一线使用表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)(例如吉非替尼、埃克替尼、阿法替尼等)口服治疗,已经体现出良好的疗效。但大多数患者在服用初始一线的TKIs治疗后出现T790M突变,引起耐药,导致疾病进展。嘉兴市第二医院呼吸与危重症医学科收治的1例EGFR突变阳性患者,在使用吉非替尼片口服治疗1年后,出现疾病进展。行基因检测后提示T790M突变阳性,改奥希替尼口服。目前患者疗效评价为部分缓解。奥希替尼对于出现T790M突变患者的治疗,有着稳定的疗效。早期及时将临床、病理和分子诊断学技术联合起来对患者治疗进行全程管理,可以为晚期非小细胞肺癌患者的治疗提供强有力的保障。
关键词: 非小细胞肺癌;表皮生长因子突变;T790M阳性;奥希替尼

Advanced lung adenocarcinoma patient with T790M mutation treated by osimertinib: A case report and literature review

Authors: 1WU Fengjie, 1GU Yangyang, 1YAO Yangwei
1 Department of Respiratory and Critical Care Medicine, Jiaxing Second Hospital, Jiaxing Zhejiang 314000, China

CorrespondingAuthor:GU Yangyang Email: guyywaitforu@163.com

Foundation: This work was supported by the Science and Technology Plan of Jiaxing, China (2017AY33029).

Abstract

Epidermal growth factor receptor (EGFR) is one of the most common driving genes of lung cancer. Oral therapy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) (gefitinib, icotinib, afatinib, etc.) has shown good efficacy in first-line patients with positive EGFR mutations. However, most patients will develop T790M mutation after taking the initial first-line TKIs treatment, leading to drug resistance and disease progression. One patient with positive EGFR mutation in our department developed disease progression after 1 year of oral treatment with gefitinib tablets. After gene testing, T790M mutation was found to be positive, and oral osimertinib was modified. At present, the efficacy evaluation of the patient is partial remission. Osimertinib has a stable effect in the treatment of patients with T790M mutation. Early and timely combination of clinical, pathological and molecular diagnostic techniques for the entire management of patient treatment can provide a strong guarantee for the treatment of patients with advanced non-small cell lung cancer.
Keywords: non-small cell lung cancer; epidermal growth factor receptor mutation; T790M positive; osimertinib