Puerto Víctor Lira
Departamento de Oncología Médica, Hospital ABC México, Sur 136 No 116 Col, Las Américas, 01120 México DF, México.
BMC Proc. 2008 Sep 24;2 Suppl 2(Suppl 2):S2. doi: 10.1186/1753-6561-2-s2-s2.
Lung cancer is the leading cause of cancer-related deaths among males and the second among females. The importance of lung cancer is a major public health problem and there is a need to find effective therapies for its management. Erlotinib has been approved to treat non-small-cell lung cancer. The author's experience in the use of erlonitib in lung cancer patients in Mexico City is described below.
The series includes 17 consecutive patients treated for advanced lung cancer. All patients had measurable disease. Treatment continues until disease progression or significant toxicity occurs. Among patients, adenocarcinoma was the most common tumor histology, followed by bronchioloalveolar tumor, and epidermoid carcinoma. Nine patients received erlotinib as first-line therapy. Of the remaining 8 patients, 4 had undergone surgery, 2 had received chemotherapy, and 2 had received combined chemotherapy and radiotherapy.
Four patients achieved complete remission of the disease, and 7 showed partial response. Five subjects experienced disease progression, and one patient showed stable disease. The most significant cases were two non-smokers women with bronchioloalveolar cancer, who remain in complete remission after erlotinib treatment. A non-smoker male patient with adenocarcinoma histology, who rejected chemotherapy and radiotherapy, it remains in complete remission after 15 months of treatment. A man with epidermoid carcinoma, with previous surgery and treated with chemotherapy and radiotherapy, with tumor recurrence, showed a complete 15-month remission with erlotinib. It was observed clinical response due to treatment with erlotinib despite the tumor histopathology, but therapeutic response was better in patients without smoking history. The most common adverse events associated with erlotinib therapy were dermatologic. After discontinuing treatment for a short period, patients were again given erlotinib without experiencing toxic effects. Hepatotoxic side effects associated to erlotinib were mild and reversible.
Data from this small series of patients support findings reported in the literature. Female non-smokers showed the best therapeutic response to erlotinib treatment. Erlotinib could be considered as a first-line therapeutic option in elderly patients with locally advanced or metastatic lung cancer, or in women with adenocarcinoma.
肺癌是男性癌症相关死亡的主要原因，在女性中位列第二。肺癌的重要性是一个重大的公共卫生问题，因此需要找到有效的治疗方法来管理它。厄洛替尼已被批准用于治疗非小细胞肺癌。以下描述了作者在墨西哥城肺癌患者中使用厄洛替尼的经验。
该系列包括17例连续接受晚期肺癌治疗的患者。所有患者均有可测量的病灶。治疗持续进行，直至疾病进展或出现显著毒性。在患者中，腺癌是最常见的肿瘤组织学类型，其次是细支气管肺泡癌和表皮样癌。9例患者接受厄洛替尼作为一线治疗。其余8例患者中，4例接受过手术，2例接受过化疗，2例接受过化疗和放疗。
4例患者实现疾病完全缓解，7例显示部分缓解。5例患者病情进展，1例患者病情稳定。最显著的病例是两名患有细支气管肺泡癌的非吸烟女性，她们在接受厄洛替尼治疗后仍处于完全缓解状态。一名具有腺癌组织学类型的非吸烟男性患者，拒绝化疗和放疗，在治疗15个月后仍处于完全缓解状态。一名患有表皮样癌的男性患者，曾接受过手术，并接受过化疗和放疗，出现肿瘤复发，使用厄洛替尼后实现了15个月的完全缓解。尽管肿瘤组织病理学不同，但观察到厄洛替尼治疗产生了临床反应，但无吸烟史的患者治疗反应更好。与厄洛替尼治疗相关的最常见不良事件是皮肤方面的。在短期停药后，再次给予患者厄洛替尼，未出现毒性作用。与厄洛替尼相关的肝毒性副作用轻微且可逆。
这一小系列患者的数据支持文献中报道的结果。女性非吸烟者对厄洛替尼治疗显示出最佳治疗反应。厄洛替尼可被视为老年局部晚期或转移性肺癌患者或腺癌女性患者的一线治疗选择。
