EGFR-TKI治疗EGFR敏感突变的晚期肺鳞癌的疗效分析

目的 探讨表皮生长因子酪氨酸激酶抑制剂（Epidermal growth factor receptor-tyrosine kinase inhibitor, EGFR-TKI）治疗EGFR敏感突变的晚期肺鳞癌患者的疗效。方法 收集20例四川大学华西医院经病理确诊、EGFR检测敏感突变、并接受EGFR-TKI治疗的Ⅳ期或术后复发转移肺鳞癌患者，分析其与EGFR-TKI的疗效关系。结果 20例EGFR敏感突变的晚期鳞癌患者接受EGFR-TKI治疗，随访资料完整。10例19-del（+），8例L858R（+），1例同时存在外显子21（L858R）点突变和外显子20（T790M）突变，1例外显子18（G719X）突变。其中部分缓解（PR）9例，疾病稳定（SD）7例，疾病进展（PD）4例。客观缓解率（ORR）45%，疾病控制率80%，中位无进展生存期（mPFS）为5.0月，中位生存期（mOS）为14.7月。结论 EGFR-TKI对部分EGFR敏感突变的鳞癌患者有一定疗效。在临床工作中，应重视这部分患者的EGFR基因检测，以便明确获益的患者。

Efficacy of Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors for Advanced Squamous Cell Lung Carcinoma Patients with Sensitive EGFR Mutations

Objective To investigate the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for advanced squamous cell lung carcinoma patients with sensitive EGFR mutations. Methods We retrospectively analyzed 20 patients with advanced or recurrent SCC harboring EGFR mutation who were treated with EGFR-TKIs in West China Hospital Sichuan University to investigate the efficacy. Results The data of 20 EGFR-mutant squamous cell lung carcinoma patients received EGFR-TKIs was sufficient. Among them, 10 patients had exon 19 deletions, 8 patients had L858R point mutations in exon 21, 1 patient had coexisted L858R and T790M mutation in exon 21, and 1 patient had G719X in exon 18. In the 20 patients, the response to EGFR-TKIs included 9 PR, 7 SD and 4 PD. The response rate was 45% and the disease control rate was 80%. The median progression-free survival(mPFS) and median overall survival(mOS) was 5.0 and 14.7 months, respectively. Conclusion Some EGFR-mutated squamous cell lung carcinoma patients could response to EGFR-TKIs. To better identify these patients, EGFR mutation status should be take into consideration.