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埃克替尼与多西他赛用于铂类化疗失败的肺腺癌患者:一项回顾性研究。

Icotinib versus docetaxel used in lung adenocarcinoma patients who failed platinum-based chemotherapy: a retrospective study.

作者信息

He Wei, Zhang Yan, Xiong Yu, Dai Feng-Juan, Fan Qing-Xia

机构信息

The Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.

出版信息

Onco Targets Ther. 2016 Jul 1;9:4037-41. doi: 10.2147/OTT.S99434. eCollection 2016.

Abstract

BACKGROUND

The efficacy and safety of epidermal growth factor receptor tyrosine kinase inhibitors have been studied worldwide. However, there are few reports directly comparing the efficacy and safety between icotinib and docetaxel as second-line treatment in lung adenocarcinoma patients who have failed platinum-based chemotherapy. This article offers insight into this field.

METHODS

A total of 137 patients with stage III or IV lung adenocarcinoma who had progressed on first-line platinum-based therapies and received icotinib or docetaxel therapy between October 2011 and February 2013 were retrospectively reviewed. Patients in the icotinib group received oral icotinib at a dose of 125 mg tid, while patients in the docetaxel group received infusion docetaxel at a dose of 75 mg/m(2) on day 1 of every 21 days (four to six cycles) until disease progression or unacceptable toxicity occurred after which best supportive care was given.

RESULTS

There was no statistically significant difference in the objective response rate (23.3% vs 12.5%, P=0.103), progression-free survival (121 days vs 106 days, P=0.083), and overall survival (307 days vs 254 days, P=0.070) between the two groups. As compared to the docetaxel group, the disease control rate (75.3% vs 54.7%, P=0.011) was significantly better in the icotinib group. In the icotinib group, the most common adverse events were rash (35.62%) and diarrhea (24.66%), whereas in the docetaxel group, elevation of transaminase (37.50%), leukopenia (50.00%), and anemia (54.69%) were the most common.

CONCLUSION

Icotinib had similar efficacy and a lower adverse events rate in epidermal growth factor receptor-unselected patients as compared to docetaxel, thereby making it an effective second-line therapy option for lung adenocarcinoma.

摘要

背景

表皮生长因子受体酪氨酸激酶抑制剂的疗效和安全性已在全球范围内得到研究。然而,对于在铂类化疗失败的肺腺癌患者中,作为二线治疗药物,埃克替尼和多西他赛之间疗效和安全性的直接比较报道较少。本文旨在深入探讨该领域。

方法

回顾性分析了2011年10月至2013年2月期间,137例接受一线铂类治疗后病情进展并接受埃克替尼或多西他赛治疗的Ⅲ期或Ⅳ期肺腺癌患者。埃克替尼组患者口服埃克替尼,剂量为125mg,每日3次,而多西他赛组患者每21天的第1天接受静脉输注多西他赛,剂量为75mg/m²(四至六个周期),直至疾病进展或出现不可接受的毒性,之后给予最佳支持治疗。

结果

两组患者的客观缓解率(23.3%对12.5%,P = 0.103)、无进展生存期(121天对106天,P = 0.083)和总生存期(307天对254天,P = 0.070)无统计学显著差异。与多西他赛组相比,埃克替尼组的疾病控制率(75.3%对54.7%,P = 0.011)显著更高。埃克替尼组最常见的不良事件为皮疹(35.62%)和腹泻(24.66%),而多西他赛组最常见的为转氨酶升高(37.50%)、白细胞减少(50.00%)和贫血(54.69%)。

结论

在表皮生长因子受体未选择的患者中,与多西他赛相比,埃克替尼具有相似的疗效且不良事件发生率更低,因此它是肺腺癌有效的二线治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5571/4936811/9c75d0183527/ott-9-4037Fig1.jpg

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