中国肺癌杂志2012，Vol.15Issue(5)：294-298,5.DOI:10.3779/j.issn.1009-3419.2012.05.08
晚期肺腺癌EGFR-TKIs对后续培美曲赛化疗的影响
Effects of EGFT-TKIs on Sequential Pemetrexed for Advanced Pulmonary Adenocarcinoma
王向迎 1刘友如 1高志强 1江银玲 1韩宝惠 1姜丽岩1
作者信息
- 1. 200030上海,上海交通大学附属胸科医院肺内科
- 折叠
摘要
Abstract
Background and objective Pemetrexed and epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) were used in patients with EGFR mutation to determine their effects. This study analyzed the influence of EGFR-TKIs on pemetrexed by observing the clinical efficacy and toxicity of pemetrexed following responses to EGFR-TKIs. Methods Pulmonary adenocarcinoma patients were divided into EGFR-TKIs and no-EGFR-TKI groups according to the targeted therapy. All patients received pemetrexed (500 mg/m ) as second (or higher)-line treatment. The Response Evaluation Criteria in Solid Tumors (version 1.0) were used to evaluate the response to pemetrexed. Adverse events were classified based on version 4.0 of the National Cancer Institute Common Toxicity Criteria. Results There were 57 patients in the EGFR-TKIs group and 56 in the no-EGFR-TKIs group. The disease control rates (DCRs) were 77.2% and 67.9% (P=0.367). The progression free survival (PFS) periods were 5.95 and 3.55 months (P=0.S3S). The overall survival (OS) periods were 10.10 and 8.24 months (P=0.432). However, these values were not statistically significant. The common toxicities of pemetrexed were hemato-logic and gastrointestinal (grades I and II). Two patients in the EGFR-TKIs group discontinued pemetrexed because of severe toxicities, which were not observed in the no-EGFR-TKIs group. Both groups had one patient who reduced dosage because of myelosuppression (grade IV). There were five and nine patients in the EGFR-TKIs and no-EGFR-TKIs groups, respectively, who delayed therapy not because of severe toxicities but due to subjective factors. Conclusion The DCRs, PFS periods, and OS periods of the patients administered with pemetrexed following EGFR-TKIs were better than those of the EGFR-TKIs group, but the differences were not statistically significant. Therefore, sequential pemetrexed administration caused negligible tenacities and can be used in adenocarcinoma therapy following responses to EGFR-TKIs.
关键词
肺肿瘤/培美曲赛/表皮生长因子酪氨酸激酶抑制剂Key words
Lung neoplasms/ Pemetrexed/ Epidermal growth factor receptor-tyrosine kinase inhibitors分类
医药卫生引用本文复制引用
王向迎,刘友如,高志强,江银玲,韩宝惠,姜丽岩..晚期肺腺癌EGFR-TKIs对后续培美曲赛化疗的影响[J].中国肺癌杂志,2012,15(5):294-298,5.
