Department of Chemotherapy, Zhejiang Cancer Hospital and Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang Province, Hangzhou, China.
J Chin Med Assoc. 2013 Sep;76(9):481-5. doi: 10.1016/j.jcma.2013.05.007. Epub 2013 Jun 13.
Adenosquamous carcinoma (ASC) of the lung is a rare subtype of nonsmall-cell lung cancer (NSCLC). To date, the efficacious targeted therapy for advanced ASC remains unclear and the epidermal growth factor receptor (EGFR) mutation rate is not well known.
We retrospectively reviewed clinical information of patients with ASC who were treated with gefitinib or erlotinib at Zhejiang Cancer Hospital between January 2007 and December 2011. Survival analysis was evaluated by the Kaplan-Meier method. EGFR mutations were assessed in part using direct sequencing methods.
In total, 49 patients with a median age of 57 years were used in this study. Thirteen patients achieved a partial response and 19 had disease stabilization. The objective response rate was 26.5%, and the disease control rate was 65.3%. The median progression-free survival and overall survival were 4.3 and 17.6 months, respectively. In 21 patients with adequate specimens for molecular analysis, 7 (33.3%) had EGFR mutations (4 with deletions within exon 19 and 3 with L858R messenger mutation in exon 21). EGFR mutations were significantly more frequent in women (4/9, 44.4%) than men (3/12, 25%), never-smokers (6/15, 40%), and smokers (1/6, 16.7%).
EGFR-tyrosine kinase inhibitor (TKI) is an effective treatment for ASC. The frequency of EGFR mutation and clinical characteristics of the EGFR mutants in ASC are similar to those of Asian patients with adenocarcinoma.
肺的腺鳞癌（ASC）是一种罕见的非小细胞肺癌（NSCLC）亚型。迄今为止，晚期 ASC 的有效靶向治疗方法尚不清楚，表皮生长因子受体（EGFR）突变率也不清楚。
我们回顾性分析了 2007 年 1 月至 2011 年 12 月在浙江肿瘤医院接受吉非替尼或厄洛替尼治疗的 ASC 患者的临床资料。采用 Kaplan-Meier 法评估生存分析。部分采用直接测序方法评估 EGFR 突变。
本研究共纳入 49 例中位年龄为 57 岁的患者。13 例患者部分缓解，19 例患者疾病稳定。客观缓解率为 26.5%，疾病控制率为 65.3%。中位无进展生存期和总生存期分别为 4.3 个月和 17.6 个月。在 21 例有足够标本进行分子分析的患者中，7 例（33.3%）有 EGFR 突变（4 例有外显子 19 缺失，3 例有外显子 21 的 L858R 突变）。EGFR 突变在女性（4/9，44.4%）中明显多于男性（3/12，25%）、从不吸烟者（6/15，40%）和吸烟者（1/6，16.7%）。
EGFR 酪氨酸激酶抑制剂（TKI）是 ASC 的有效治疗方法。EGFR 突变的频率和 ASC 中 EGFR 突变患者的临床特征与亚洲腺癌患者相似。
