摘要
目的探讨程序性死亡因子-1(PD-1)抑制剂联合抗血管生成药物治疗表皮生长因子受体(EGFR)突变晚期肺腺癌患者的疗效和安全性。方法纳入郑州大学第一附属医院2019年1月至2021年6月收治的三线及以上应用PD-1抑制剂联合抗血管生成药物治疗的EGFR基因突变晚期肺腺癌患者56例,进行疗效和安全性分析。结果56例患者均进行了EGFR基因检测,EGFR基因突变类型分别为EGFR 19外显子缺失突变24例(42.9%)、EGFR 21外显子L858R突变29例(51.8%)、EGFR 18外显子G719X突变2例(3.6%)及EGFR 21外显子L861Q突变1例(1.8%),其中合并EGFR 20外显子T790M突变17例(30.4%)。所有患者客观缓解率和疾病控制率分别为23.2%、71.4%,中位疾病无进展生存期(PFS)为4.9个月。合并EGFR T790M突变患者的PFS明显劣于未合并EGFR T790M突变患者(χ^(2)=9.250,P=0.002)。但EGFR 19外显子缺失突变、EGFR 21外显子L858R突变与少见突变患者PFS比较差异无统计学意义(χ^(2)=0.034,P=0.983)。结论PD-1抑制剂联合抗血管生成药物在EGFR基因突变晚期肺腺癌患者后线治疗中显示出较好疗效,值得进一步探索。
Objective To explore efficacy and safety of programmed cell death protein 1(PD-1)inhibitor combined with anti-angiogenesis drugs in the treatment of advanced lung adenocarcinoma patients with epidermal growth factor receptor(EGFR)mutation.Methods Fifty-six lung adenocarcinoma patients with EGFR mutation were treated with PD-1 inhibitor combined with anti-angiogenesis drugs in third-line therapy or above in the First Affiliated Hospital of Zhengzhou University from January 2019 to June 2021,the efficacy and adverse reactions were analyzed.Results The EGFR gene status of all the 56 patients were determined.The type of EGFR mutation was 24 patients(42.9%)with EGFR exon 19 deletion mutation,29 patients(51.8%)with EGFR exon 21 L858R mutation,2 patients with EGFR exon 18 G719X mutation(3.6%)and 1 patient with EGFR exon 21 L861Q mutation(1.8%),and 17 patients(30.4%)combined with EGFR 20 exon T790M mutation.The overall response rate and disease control rate were 23.2%and 71.4%.The median progression free survival(PFS)was 4.9 months.The PFS of patients with EGFR 20 exon T790M mutation was significantly worse than that without EGFR 20 exon T790M mutation(χ^(2)=9.250,P=0.002).There was no significant difference in the PFS among EGFR 19 exon deletion mutation,EGFR 21 exon L858R mutation and rare mutation(χ^(2)=0.034,P=0.983).Conclusion PD-1 inhibitor combined with anti-angiogenesis drugs shows good antitumor efficacy in the posterior treatment of patients with EGFR mutation,which is worthy of further exploration.
作者
耿童童
耿迪
胡浩强
申淑景
李醒亚
GENG Tongtong;GENG Di;HU Haoqiang;SHEN Shujing;LI Xingya(Department of Oncology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Radiotherapy,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《肿瘤基础与临床》
2022年第4期303-308,共6页
journal of basic and clinical oncology
基金
吴阶平医学基金会资助项目(320.6750.19088-14)。
关键词
肺腺癌
表皮生长因子受体突变
程序性死亡因子-1抑制剂
抗血管生成
lung adenocarcinoma
epidermal growth factor receptor mutations
programmed cell death protein 1 inhibitor
anti-angiogenesis
