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
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.