吉非替尼耐药的晚期非小细胞肺癌联合重组人血管内皮抑素解救治疗的临床研究

目的探讨晚期非小细胞肺癌(NSCLC)患者吉非替尼治疗失败后,联合恩度解救治疗的疗效和生存。方法确定为吉非替尼治疗失败的晚期NSCLC患者接受联合恩度治疗,具体用法:恩度15 mg/d,连续静脉输注1 d,休息7 d,21 d/周期。观察患者联合治疗的疗效,生存和毒性结果。结果 1例获得部分缓解(PR)(10%),6例稳定(SD)(60%),3例进展(PD)(30%);客观缓解率(ORR)为10%,疾病控制率(DCR)为70%;联合治疗后的中位PFS为4.2个月(95%CI:3.21个月~5.19个月);联合治疗开始后的中位OS是8个月(95%CI:4.96个月~11.04个月)。DCR、PFS和OS与患者的性别、年龄、PS评分、病理类型及易瑞沙服药时间长短均无相关性。结论吉非替尼治疗失败后联合恩度解救治疗可使部分患者疾病获得稳定,延长生存时间,并且毒性可以耐受,可以扩大样本量进行深入研究。

Clinical study on the relief treatment of the combined recombinant human endostatin after failed treatment of gefitinib for advanced non-small cell lung cancer

Objective To investigate the efficacy and survival of the relief treatment of the combined endostar after the failure of gefitinib in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Patients with pathologically confirmed stage IV non-small cell lung cancer who had the failed disease control with gefitinib were retrospectively reviewed. After acquired TKI resistance,patients received endostar(15 mg/day,Iv 1d,rested for 7 d,21 d as a cycle).The efficacy and toxicities of the combined treatment were observed.Results One patient achieved partial remission(PR)(10%),6 patients had stable disease(SD)(60%),3 had progressive disease(PD)(30%),the objective remission rate(OBR) was 10% and the disease control rate(DCR) was 70%.Median progression-free survival was 4.2 months(95% CI,3.21-5.19 months),whereas median OS period was 8.0 months(95% CI,4.96-11.04 months).DCR and PFS and OS were not correlated with the sex,age,performance status(PS) score,histologic types and the drug intake length of iressa.Conclusion After the failed attempt of gefitnib treatment,the combined endostar treatment can stabilize some patients,and prolong their survival time with tolerable toxicities.More subjects can be enrolled to enhance the validity of the research.