培美曲塞治疗EGFR-TKI获得性耐药的晚期非小细胞肺癌疗效观察

目的观察培美曲塞治疗EGFR-TKI获得性耐药的晚期非小细胞肺癌（非鳞癌）的疗效。方法14例患者入组，2例既往未接受化疗患者采用培美曲塞联合顺铂方案，培美曲塞 500 mg/m2，静脉滴注，d1；DDP 25 mg/m2，静脉滴注d1~d3。12例既往曾接受含铂两药联合方案化疗患者（不含培美曲塞），采用培美曲塞单药化疗500 mg/m2，d1；21天为一周期。所有患者均接受2周期以上治疗。结果14例患者均接受2周期以上治疗，可评价疗效。治疗有效率35.7%（5/14）,疾病控制率71.4%（10/14）,中位疾病进展时间（PFS）为6.3月，中位生存期为12.5月。结论培美曲塞治疗EGFR-TKI治疗失败后晚期非小细胞肺癌取得一定疗效，不良反应可以耐受，值得临床进一步研究。

Efficacy of Pemetrexed Chemotherapy in Advanced Non-small Cell Lung Cancer with EGFR-TKI Resistence

Objective To observe the efficacy and toxicity of Pemetrexed chemotherapy in advanced non-small cell lung cancer,failed to EGFR-TKI treatment.Methods Fourteen patients were enrolled.Two patients without chemotherapy history were treated by pemetrexed combined with cisplatin;pemetrexed 500 mg/m2,intravenously,d1;DDP 25 mg/m2,d1~d3,intravenously.Twelve cases received platinum-based chemotherapy were treated with pemetrexed 500 mg/m2 alone,21 days for one cycle.All patients received at least 2 cycles of treatment.Results All 14 patients had been evaluated.Overall response rate was 35.7%(5/14),and disease control rate was 71.4%(10/14).Median progression-free survival(PFS) and overall survival(OS) were 6.3 months and 12.5 months,respectivly.Conclusion Pemetrexed might improve clinically outcomes with well tolerance for advanced non-small cell lung cancer resisted to EGFR-TKI.