阿帕替尼联合埃克替尼一线治疗EGFR敏感突变晚期非小细胞肺癌的效果及安全性

目的探讨阿帕替尼联合埃克替尼一线治疗表皮生长因子受体敏感突变的晚期非小细胞肺癌的效果及安全性。方法筛选广东医科大学附属医院2017年10月至2019年4月期间收治的45例表皮生长因子受体敏感突变晚期非小细胞肺癌患者,随机分为观察组22例及对照组23例,观察组予阿帕替尼联合埃克替尼治疗,对照组予埃克替尼治疗,分析两组患者的客观缓解率、疾病控制率、无进展生存时间及不良反应发生情况。结果观察组和对照组的客观缓解率分别为77.27%、65.22%,疾病控制率分别为95.45%、91.30%,组间比较差异无统计学意义(P0.05)。观察组的中位无进展生存时间为13.7个月,长于对照组的9.6个月,差异有统计学意义(P0.05)。观察组1～4级高血压和蛋白尿发生率均高于对照组,差异有统计学意义(P0.05),两组间1～4级消化道反应、皮疹、肝功能损害、乏力、手足综合征比较,差异无统计学意义(P0.05)。两组间严重不良反应(3～4级)发生率比较,差异无统计学意义(P0.05)。结论阿帕替尼联合埃克替尼一线治疗表皮生长因子受体敏感突变的晚期非小细胞肺癌,可延长患者的无进展生存时间,安全性可接受,但尚需大规模、多中心的临床试验进一步证实。

Efficacy and safety of apatinib combined with icotinib as first-line treatment for advanced non-small cell lung cancer with EGFR sensitive mutation

Objective To investigate the efficacy and safety of apatinib combined with icotinib as first-line treatment for advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) sensitive mutation.Methods A total of 45 patients with advanced NSCLC with EGFR sensitive mutation admitted to and treated in the Affiliated Hospital of Guangdong Medical University from October 2017 to April 2019 were screened.They were randomly divided into the observation group(n=22) and the control group(n=23).The observation group was treated with apatinib combined with icotinib,while the control group was treated with icotinib.The objective remission rate,disease control rate,progression free survival time and adverse reactions(ARs) of the two groups of patients were analyzed.Results The objective remission rates between the observation group and the control group were 77.27% and 65.22% respectively,and the disease control rates were 95.45% and 91.30% respectively,all without statistically significant differences between the two groups (P>0.05).The median progression free survival time of the observation group was 13.7 months,that was longer than that of 9.6 months in the control group,with statistically significant difference(P<0.05).The incidences of grade 1-4 hypertension and proteinuria in the observation group were all higher than those in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in all the incidences of grade 1-4 gastrointestinal reactions,rash,hepatic function damage,fatigue,hand-foot syndrome and serious ARs (grade 3-4) between the two groups (P>0.05).Conclusion Apatinib combined with icotinib as first-line treatment for advanced NSCLC with EGFR sensitive mutation can prolong the progression free survival time of patients with acceptable safety,but it needs to be further confirmed by large-scale multicenter clinical trials.