新医学2016，Vol.47Issue(7)：472-476,5.DOI:10.3969/j.issn.0253-9802.2016.07.011
贝伐珠单抗联合E GFR-TKI治疗E GFR外显子19或21突变晚期非小细胞肺癌的疗效差异
Clinical efficacy of bevacizumab combined with EGFR-TKI in treatment of advanced non-small cell lung cancer with EGFR exon 19 or 21 mutation
林顺欢 1江冠铭 1刘淳 1郑锐年 1林钦雄 1谭钦全 1刘克军 1卢志斌 1贾筠1
作者信息
- 1. 523059 东莞，东莞市人民医院肿瘤中心内科
- 折叠
摘要
Abstract
Objective To compare the clinical efficacy of epidermal growth factor receptor-tyrosine kinases inhibitor (EGFR-TKI)alone and bevacizumab in combination with EGFR-TKI in the treatment of ad-vanced non-small cell lung cancer (NSCLC)with EGFR exon 19 or 21 mutation. Methods In total,100 ad-vanced NSCLC patients with EGFR mutation,50 with EGFR exon 19 mutation and 50 with EGFR exon 21 mu-tation,were randomly divided into two groups. In group A,patients were treated with bevacizumab in combina-tion with gefitinib until disease progression and those in group B were given with gefitinib alone until disease progression. The incidence of adverse responses,objective remission rate (ORR),progression-free survival (PFS)and overall survival (OS)were statistically compared between two groups. Results For NSCLC pa-tients with exon 19 mutation,the ORR in group A was 92%,significantly higher compared with 68%in group B (P<0.05). For their counterparts with exon 21 mutation,the ORR in group A was 88%,considerably higher than 60% in group B (P<0.05). For patients with exon 19 mutation,the median PFS in group A was 12.5 months,significantly longer compared with 9.0 months in group B (P<0.05). The median PFS of pa-tients with exon 21 mutation in group A was 8.9 months,remarkably higher than 7.0 months in group B (P<0.01). For patients with exon 19 mutation,the median OS did not significantly differ between groups A and B (P>0.05). The median PFS of patients with exon 21 mutation in group A was 8.9 months,remarkably higher than 7.0 months in group B (P<0.01). For patients with exon 21 mutation,the median OS in group A was 26.7 months,significantly longer compared with 23.8 months in group B (P<0.01 ). For NSCLC patients with exon 19 and 21 mutation,the incidence of tolerable hypertension and albuminuria in group A was signifi-cantly higher than that in group B (both P<0.05 ). Conclusions Bevacizumab in combination with EGFR-TKI serves as a novel option in the management of advanced NSCLC with EGFR mutation,especially those with exon 21 mutation. The PFS and OS of patients receiving bevacizumab combined with EGFR-TKI are prolonged compared with those treated with EGFR-TKI alone.关键词
贝伐珠单抗/表皮生长因子受体-酪氨酸激酶抑制剂/非小细胞肺癌/吉非替尼/无进展生存期/总体生存期Key words
Bevacizumab monoclonal antibody/Eidermal growth factor receptor-tyrosine kinase in-hibitor/Non-small cell lung cancer/Gefitinib/Progression-free survival/Overall sur-vival引用本文复制引用
林顺欢,江冠铭,刘淳,郑锐年,林钦雄,谭钦全,刘克军,卢志斌,贾筠..贝伐珠单抗联合E GFR-TKI治疗E GFR外显子19或21突变晚期非小细胞肺癌的疗效差异[J].新医学,2016,47(7):472-476,5.
