目的：探讨埃克替尼对非小细胞肺癌(non-small cell lung cancer，NSCLC)EGFR 21外显子L861Q/L833F突变的临床疗效。方法：回顾性分析17例埃克替尼治疗EGFR 21外显子少见突变的NSCLC，服用至病情进展或出现不可耐受的毒副作用，并观察疗效。结果：17例L861Q/L833F突变患者中L861Q突变17例，中位生存时间2.2个月，L833F突变1例，中位生存时间4.2个月。L833F突变患者生存时间稍长。复合突变与单纯突变相比，复合突变中位生存时间更长(L861Q突变2.1个月vs. 5.6个月，P=0.065)。结论：埃克替尼在EGFR基因21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 21 rare mutations
Objective: To investigate the efficacy of icotinib in patients with non-small cell lung cancer (NSCLC) that carrying L861Q/L833F in EGFR exon 21. Methods: We retrospectively analysed 17 cases of EGFR 21 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: Seventeen patients with L861Q/L833F mutations were enrolled. Mutations including L861Q and L833F mutations were observed in 17 and 1 patients, respectively. In total, the median progression-free survival (PFS) were 2.2 months, respectively. Patients with L833F mutation manifested the longest median PFS (4.2 months), followed by those with L861Q (2.2 months). Patients with complex mutations show a better PFS than those with single mutations (L861Q mutations 2.1 months vs. 5.6 months, P=0.065). Conclusion: Icotinib is less effective in patients with exon 21 uncommon mutations than in those with common mutations. Patients with complex mutations benefited more from icotinib than those with single mutations.