Liam Chong-Kin, Pang Yong-Kek, Leow Chai-Hooi
Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Respirology. 2006 May;11(3):287-91. doi: 10.1111/j.1440-1843.2006.00840.x.
To describe the efficacy of monotherapy with the epidermal growth factor receptor-tyrosine kinase inhibitor, gefitinib in patients with locally advanced and metastatic primary lung adenocarcinoma.
A retrospective analysis was undertaken of patients who had locally advanced or metastatic lung adenocarcinoma treated with gefitinib 250 mg orally once daily until disease progression. All patients had either been previously treated with systemic cytotoxic chemotherapy and/or radiotherapy or had declined chemotherapy or were medically not fit for cytotoxic chemotherapy.
A total of 23 patients (13 men) (15 never smokers) with a median age of 51 years (range 35-79 years) received gefitinib monotherapy. Disease control occurred in 14 patients (61%); there was a reduction in the size of the primary and/or metastatic tumours (partial response (PR)) in 11 patients (48%), and 3 patients (13%) had stable disease. The response rate was significantly higher in those who had never smoked (10 of 15 (67%)) compared with that of smokers (1 of 8 (13%)) (odds ratio (95% confidence interval), 14.0 (1.33-147.43) P=0.027). In total, 11 of 18 patients (61%) with a WHO performance status 1 or 2 showed a PR, whereas none with a performance status 3 or 4 responded (P=0.037). Response was not affected by the patient's age, gender, disease stage, prior chemotherapy treatment, interval between diagnosis and commencement of gefitinib or the development of skin toxicity. The median time to symptom improvement was 1.5 (range 0.5-6) weeks. The median progression-free survival time was: 60 (range 15-138) weeks in patients with PR and 34 (range 7-38) weeks in patients with stable disease (P=0.368).
When given alone, gefitinib showed significant antitumour activity in patients with locally advanced and metastatic primary lung adenocarcinoma. An objective response was observed more frequently in never smokers and exclusively in patients with good performance status.
描述表皮生长因子受体酪氨酸激酶抑制剂吉非替尼单药治疗局部晚期和转移性原发性肺腺癌患者的疗效。
对接受吉非替尼每日口服250mg直至疾病进展的局部晚期或转移性肺腺癌患者进行回顾性分析。所有患者既往均接受过全身细胞毒性化疗和/或放疗，或拒绝化疗，或因医学原因不适合进行细胞毒性化疗。
共有23例患者（13例男性）（15例从不吸烟者）接受吉非替尼单药治疗，中位年龄51岁（范围35 - 79岁）。14例患者（61%）疾病得到控制；11例患者（48%）原发和/或转移肿瘤大小缩小（部分缓解（PR）），3例患者（13%）疾病稳定。从不吸烟者的缓解率（15例中的10例（67%））显著高于吸烟者（8例中的1例（13%））（优势比（95%置信区间），14.0（1.33 - 147.43），P = 0.027）。18例世界卫生组织体能状态为1或2的患者中，11例（61%）显示部分缓解，而体能状态为3或4的患者均无缓解（P = 0.037）。缓解不受患者年龄、性别、疾病分期、既往化疗治疗、诊断与开始使用吉非替尼之间的间隔时间或皮肤毒性发生情况的影响。症状改善的中位时间为1.5（范围0.5 - 6）周。部分缓解患者的中位无进展生存时间为：60（范围15 - 138）周，疾病稳定患者为34（范围7 - 38）周（P = 0.368）。
单独使用时，吉非替尼在局部晚期和转移性原发性肺腺癌患者中显示出显著的抗肿瘤活性。在从不吸烟者中更频繁地观察到客观缓解，且仅在体能状态良好的患者中出现。
