奥希替尼治疗经埃克替尼一线治疗后进展并继发T790M突变的肺腺癌1例
| 作者: |
1黄锦宏,
1张晓东,
1由振华,
1程易,
1赵云根
1 徐州医科大学附属常熟医院呼吸内科，江苏 常熟 215500 |
| 通讯: |
黄锦宏
Email: john126272@sohu.com |
| DOI: | 10.3978/j.issn.2095-6959.2020.01.043 |
摘要
徐州医科大学附属常熟医院收治1例埃克替尼治疗进展后继发T790M突变的肺腺癌接受二线奥希替尼治疗的女性患者。该患者70岁，反复咳嗽咳痰15年，加重半月；CT提示右肺中叶实变影，大量胸腔积液；病理报告：(胸水细胞块)转移性腺癌，倾向肺来源；血液基因检测示EGFR 19Del合并TP53突变；口服埃克替尼125 mg，每天3次，10个月后疾病进展，再次血液基因检测T790M突变，口服奥希替尼80 mg，每天1次，随访至今(9个月)，疾病达到部分缓解(partial response，PR)。因此，晚期非小细胞肺癌患者治疗前应明确基因状态，对于阳性患者给与表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors，EGFR-TKIs)治疗，可以使患者获得更长的总生存期和更好的生活质量。
关键词：
非小细胞肺癌；T790M；奥希替尼
A case of osimertinib for lung adenocarcinoma patient with secondary T790M mutation after icotinib
CorrespondingAuthor: HUANG Jinhong Email: john126272@sohu.com
DOI: 10.3978/j.issn.2095-6959.2020.01.043
Abstract
A lung adenocarcinoma patient who had secondary T790M mutation after icotinib was admitted to the Affiliated Changshu Hospital of Xuzhou Medicinal University with second-line osimertinib. The patient is a 70-year-old woman having recurrent cough and phlegm for 15 years and had been aggravated in the past half a month. CT showed consolidation of right middle lob and pleural effusion; pathology report expressed the metastatic adenocarcinoma of pleural fluid cell mass from lung; blood gene detection said EGFR 19Del combined with TP53 mutation said TP53 mutation again after 10-month oral icotinib 125 mg, 3 times a day. The 9-month follow-up visit after oral osimertinib 80 mg once a day reported partial response (PR). Therefore, patients with advanced non-small cell lung cancer should have a clear genetic status before the treatment. The positive patients with TKI treatment can get longer overall survival and have a better life.
Keywords：
non-small cell lung cancer; T790M; osimertinib