论著 Original Article

埃克替尼对非小细胞肺癌EGFR 18外显子突变的临床疗效

Published at: 2017年第37卷第4期

黄韵坚 1 , 陈燕坪 2 , 庄武 1 , 黄章洲 1 , 朱有才 3 , 杜开齐 3 , 方美玉 4 , 王晓江 2 , 师怡 2 , 林贤东 2 , 许春伟 2 , 陈刚 2
1 福建医科大学附属福建省肿瘤医院胸部肿瘤内科,福州 350014
2 福建医科大学附属福建省肿瘤医院病理科, 福州 350014
3 浙江省荣军医院胸部疾病中心,浙江 嘉兴 314000
4 浙江省肿瘤医院综合肿瘤内科,杭州 310022
通讯作者 武 庄 Email: aoshitianyi@126.com
DOI: 10.3978/j.issn.2095-6959.2017.04.014
基金:
国家临床重点专科建设项目 2013
福建省科技厅引导性项目 2016Y0019
福建省科技厅引导性项目 2015Y0011
浙江省卫生科研计划基金 2013KYB051
浙江省中医药局科研基金 2013ZQ005
浙江省科技厅公益类科研计划 2015C33194

摘要

目的:探讨埃克替尼对非小细胞肺癌(non-small cell lung cancer,NSCLC)EGFR 18外显子G719X/E709X/G724S的临床疗效。方法:回顾性分析24例埃克替尼治疗EGFR 18外显子少见突变的NSCLC患者,服用至病情进展或出现不可耐受的毒副作用,比较疗效。结果:24例G719X/E709X/G724S突变患者中G719X突变19例,中位无进展生存时间2.8个月,E709X突变3例,中位无进展生存时间3.1个月,G724S突变2例,中位无进展生存时间3.5个月。G724S突变患者生存时间稍长。复合突变与单纯突变相比,复合突变中位无进展生存时间更长(G719X突变3.3个月vs. 2.6个月,P=0.029;E709X突变7.2个月vs. 2.7个月,P=0.225)。结论:埃克替尼在EGFR基因18外显子少见突变的疗效上比传统敏感突变未见明显优势,但复合突变比单纯突变临床获益更多。


Clinical efficacy of icotinib in patients with advanced non-small cell lung cancer harboring EGFR exon 18 mutations

Abstract

Objective: To investigate the efficacy of icotinib in patients with non-small cell lung cancer (NSCLC) that carrying G719X/E709X/G724S in EGFR exon 18. Methods: We retrospectively analysed 24 cases of EGFR 18 exon rare mutation NSCLC patients until the progress of the disease or the emergence of the side effects and clinical efficacy was observed after months followed-up. Results: Twenty-four patients with G719X/E709X/G724S mutations were enrolled. Mutations including G719X, E709X and G724S mutations were observed in 19, 3 and 2 patients, respectively. In total, the median progression-free survival (PFS) were 3.1 months, respectively. Patients with G724S mutation manifested the longest median PFS (3.5 months), followed by those with E709X (3.1 months) and G719X (2.8 months). Patients with complex mutations showed a better PFS than those with single mutations (G719X mutations 3.3 months vs. 2.6 months, P=0.029; E709X 7.2 months vs. 2.7 months, P=0.225). Conclusion: Icotinib is less effective in patients with exon 18 uncommon mutations than in those with common mutations. Patients with complex mutations benefited more from icotinib than those with single mutations.


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引用

引用本文: 韵坚 黄, 燕坪 陈, 武 庄, 章洲 黄, 有才 朱, 开齐 杜, 美玉 方, 晓江 王, 怡 师, 贤东 林, 春伟 许, 刚 陈. 埃克替尼对非小细胞肺癌EGFR 18外显子突变的临床疗效[J]. 临床与病理杂志, 2017, 37(4): 729-734.
Cite this article as: HUANG Yunjian, CHEN Yanping, ZHUANG Wu, HUANG Zhangzhou, ZHU Youcai, DU Kaiqi, FANG Meiyu, WANG Xiaojiang, SHI Yi, LIN Xiandong, XU Chunwei, CHEN Gang . Clinical efficacy of icotinib in patients with advanced non-small cell lung cancer harboring EGFR exon 18 mutations[J]. Journal of Clinical and Pathological Research, 2017, 37(4): 729-734.