【摘要】 徐州医科大学附属常熟医院收治1例埃克替尼治疗进展后继发T790M突变的肺腺癌接受二线奥希替尼治疗的女性患者。该患者70岁,反复咳嗽咳痰15年,加重半月;CT提示右肺中叶实变影,大量胸腔积液;病理报告:(胸水细胞块)转移性腺癌,倾向肺来源;血液基因检测示EGFR 19Del合并TP53突变;口服埃克替尼125 mg,每天3次,10个月后疾病进展,再次血液基因检测T790M突变,口服奥希替尼80 mg,每天1次,随访至今(9个月),疾病达到部分缓解(partial response,PR)。因此,晚期非小细胞肺癌患者治疗前应明确基因状态,对于阳性患者给与表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKIs)治疗,可以使患者获得更长的总生存期和更好的生活质量。更多还原

【Abstract】 A lung adenocarcinoma patient who had secondary T790 M mutation after icotinib was admitted to the Affiliated Changshu Hospital of Xuzhou Medicinal University with second-line osimertinib.The patient is a 70-yearold woman having recurrent cough and phlegm for 15 years and had been aggravated in the past half a month.CT showed consolidation of right middle lob and pleural effusion;pathology report expressed the metastatic adenocarcinoma of pleural fluid cell mass from lung;blood gene detection said EGFR 19 Del combined with TP53 mutation said TP53 mutation again after 10-month oral icotinib 125 mg,3 times a day.The 9-month follow-up visit after oral osimertinib 80 mg once a day reported partial response(PR).Therefore,patients with advanced non-small cell lung cancer should have a clear genetic status before the treatment.The positive patients with TKI treatment can get longer overall survival and have a better life.更多还原