【摘要】 目的探讨晚期非小细胞肺癌患者经表皮生长因子受体-酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitor,EGFR-TKI)治疗进展后加用阿帕替尼治疗的临床疗效和安全性。方法选取2017年12月至2019年2月深圳市人民医院自愿入组的7例晚期非小细胞肺癌患者为研究对象,所有患者均为使用EGFR-TKI治疗后出现疾病进展,入组后继续口服原EGFR-TKI,并加用阿帕替尼联合治疗,直至疾病进展停药。通过客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、中位无进展生存(median progress-free survival,mPFS)时间、中位总生存(median overall survival,mOS)时间分析临床疗效,通过不良反应分析安全性。所有患者随访至死亡或2021年9月18日。结果 7例患者均可进行疗效评价,部分缓解4例、疾病稳定2例、疾病进展1例,ORR为57.1%,DCR为85.7%,mPFS时间为15个月,mOS时间为31个月。不良反应为高血压、手足综合征、蛋白尿、腹泻、咳血、牙龈出血,均为1～2级不良反应。结论晚期非小细胞肺癌患者经EGFR-TKI治疗进展后,继续原EGFR-TKI治疗,并加用阿帕替尼联合靶向治疗,可提高近期疗效和远期生存获益,患者耐受性较好,是克服EGFR-TKI耐药的一种选择。更多还原

【Abstract】 Objective To investigate the clinical efficacy and safety of the combination of apatinib and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) for advanced non-small cell lung cancer (NSCLC) treated with EGFR-TKI resistance.Method From December 2017 to February 2019,7 cases of advanced NSCLC patients in Shenzhen People’s Hospital were volunteers,and had taken EGFR-TKI before their disease progressed.In our study,they took the initial EGFR-TKI and apatinib together until the disease progression and withdrawal.Objective response rate (ORR),disease control rate (DCR),median progress-free survival (mPFS) and median overall survival (mOS) were used to analyze the clinical efficacy,and the safety was analyzed by adverse reactions.All patients were followed up until death or September 18,2021.Result All 7 patients were evaluated for efficacy,including partial response in 4 cases,stable disease in 2 cases and progressive disease in 1 case.The ORR of our study was 57.1%,the DCR was 85.7%,mPFS was 15 months,and mOS was 31 months.Adverse effects were hypertension,hand-foot syndrome,proteinuria,diarrhea,hemoptysis and bleeding gums,all of them were grade 1 and 2.Conclusion The combination therapy of EGFR-TKI and apatinib can improve the efficacy and long-term survival benefit for the patient with EGFR-TKI resistance and the side effect is tolerated.The combination therapy of EGFR-TKI and apatinib is an optional choice for the NSCLC with EGFR-TKI resistance.更多还原