对比EGFR-TKIs治疗EGFR突变状态未明晚期NSCLC疗效研究

目的探讨对比表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhibitors,EGFR-TKIs)一线、维持及二线治疗EGFR突变状态未明晚期非小细胞肺癌(non-small-cell lung cancer,NSCLC)的疗效。方法回顾性分析接受EGFR-TKIs治疗的57例EGFR突变状态未明晚期NSCLC,按照接受EGFR-TKIs治疗的时机分为EGFR-TKIs治疗一线组(19例)、维持组(18例)和二线组(20例),按照RECIST标准进行疗效评价。结果一线组、维持组和二线组客观有效率(52.6%vs 38.9%vs 35.0%,P=0.098)、中位无进展生存期(4.0月vs 7.8月vs 2.2月,P=0.417)差异无统计学意义,但一线组患者总生存期较维持组和二线组差(8.7月vs 20.0月vs 19.1月,P=0.009)。结论 EGFR突变状态未明晚期NSCLC EGFR-TKIs一线、维持和二线治疗的客观有效率和中位无进展生存期相似,但EGFR-TKIs一线治疗总生存期较短,建议EGFR-TKIs用于维持或二线治疗EGFR突变状态未明晚期NSCLC。

Efficacy of EGFR-TKIs for advanced NSCLC with unknown EGFR mutation status as first-line therapy,maintenance therapy or second-line therapy

Objective: To compare the efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) as first-line therapy, maintenance therapy and second-line therapy for advanced non-small-cell lung cancer (NSCLC) with unknown EGFR mutation status. Methods: Fifty-seven advanced NSCLC patients with unknown EGFR mutation status were enrolled and divided into EGFR-TKI first-line therapy group (n=19), maintenance therapy group (n=18) and second-line therapy group (n=20). RECIST was used to evaluate therapy response. Results: There was no significant difference among first-line, maintenance and second-line therapy groups in the objective response rate (ORR) (52.6% vs 38.9% vs 35.0%, P=0.098) and the median progression-free survival (PFS) (4.0 months vs 7.8 months vs 2.2 months, P=0.417). However, the overall survival (OS) of first-line group was significantly lower than those of maintenance and second-line therapy groups (8.7 months vs 20.0 months vs 19.1 months, P=0.009). Conclusion: EGFR-TKIs should be used as maintenance therapy or second-line therapy in advanced non-small-cell lung cancer with unknown EGFR mutation status. © 2015, Journal of Practical Oncology, Editorial Board. All right reserved.