Abstract：Objective: To investigate the effect and prognosis of EGFR-TKI combined with PP (pemetrexed+cisplatin) chemotherapy in the treatment of epidermal growth factor receptor (EGFR)-mutated advanced lung adenocarcinoma. Methods: This study was conducted from January 2019 to January 2021. A total of 105 patients with EGFR-mutated advanced lung adenocarcinoma were selected, and divided into the combination group (54 cases) and the control group (51 cases) according to the treatment plan. The control group was treated with second-generation EGFR-TKI (dacomitinib). The combination group was treated with dacomitinib and PP chemotherapy, with 21 days as a cycle. Efficacy, tumor markers and progression-free survival were compared between the two groups. Results: The objective remission rate and disease control rate in the combination group (27.78% and 88.89%) were higher than those in the control group (9.8% and 68.63%) (P<0.05). The difference values of serum carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and cytoplasmic thymidine kinase (TK1) levels before and after treatment in the combination group were higher than those in the control group (P<0.05). The incidence rates of thrombocytopenia, diarrhea, enteritis, stomatitis, decreased appetite, liver dysfunction, renal dysfunction and rash in the two groups were close (P>0.05). The 1-year and 2-year progression-free survival rates in the combination group (81.48% and 35.19%) were higher than those in the control group (62.75% and 17.65%) (P<0.05). The median progression-free survival time of the combination group and control group were 19.0 months and 15.1 months. There is a difference in the survival curves between the two groups (P<0.05). Conclusion: Second-generation EGFR-TKI combined with PP chemotherapy can significantly prolongs progression-free survival, without increasing adverse reactions.
林承奎, 朱成圣, 王宇. EGFR-TKI联合化疗治疗EGFR敏感突变晚期肺腺癌的效果及预后分析[J]. 河北医学, 2024, 30(5): 871-874.
LIN Chengkui, ZHU Chengsheng, WANG Yu. Effect and Prognosis of EGFR-TKI Combined with Chemotherapy in the Treatment of EGFR-Mutated Advanced Lung Adenocarcinoma. HeBei Med, 2024, 30(5): 871-874.
[1] Qiao M,Jiang T,Liu X,et al.Immune checkpoint inhibitors in EGFR-Mutated NSCLC:dusk or dawn[J].Thorac Oncol,2021,16(8):1267-1288. [2] Ye L,Chen X,Zhou F.EGFR-mutant NSCLC:emerging novel drugs[J].Curr Opin Oncol,2021,33(1):87-94. [3] Dong RF,Zhu ML,Liu MM,et al.EGFR mutation mediates resistance to EGFR tyrosine kinase inhibitors in NSCLC:From molecular mechanisms to clinical research[J].Pharmacol Res,2021,5(167):1055-1063. [4] Mok TS,Cheng Y,Zhou X,et al.Updated overall survival in a randomized study comparing dacomitinib with gefitinib as first-line treatment in patients with advanced non-small-cell lung cancer and EGFR-activating mutations[J].Drugs,2021,81(2):257-266. [5] 龚发敏,刘富越,马雪,等.第1代表皮生长因子受体酪氨酸激酶抑制药的个体化用药研究现状[J].中国临床药理学杂志,2023,39(7):1055-1059. [6] 季栋梁.安罗替尼和厄洛替尼治疗晚期非鳞非小细胞肺癌的临床疗效与安全性分析[J].中国现代应用药学,2021,38(22):2886-2889. [7] 中华医学会肿瘤学分会,中华医学会杂志社.中华医学会肿瘤学分会肺癌临床诊疗指南(2021版)[J].中华医学杂志,2021,101(23):1725-1757. [8] Litiere S,Bogaerts J.Imaging endpoints for clinical trial use:a RECIST perspective[J].J Immunother Cancer,2022,10(11):5092-5098. [9] Cheng Y,Mok TS,Zhou X,et al.Safety and efficacy of first-line dacomitinib in Asian patients with EGFR mutation-positive non-small cell lung cancer:Results from a randomized,open-label,phase 3 trial (ARCHER 1050)[J].Lung Cancer,2021,4(154):176-185. [10] Zhong WZ,Wang Q,Mao WM,et al.Gefitinib versus vinorelbine plus cisplatin as adjuvant treatment for stage II-IIIA (N1-N2) EGFR-mutant NSCLC:final overall survival analysis of CTONG1104 phase iii trial[J].Clin Oncol,2021,39(7):713-722. [11] 吕艳红,张 冬,郭 慧.达可替尼一线治疗EGFR Exon19/21突变型晚期非小细胞肺癌的临床疗效观察[J].现代肿瘤医学,2022,30(12):2177-2180. [12] Ji W,Shen J,Wang B,et al.Effects of dacomitinib on the pharmacokinetics of poziotinib in vivo and in vitro[J].Pharm Biol,2021,59(1):457-464.
2024, Vol. 30 
冀公网安备13080202000677号