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表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)对表皮生长因子受体(EGFR)突变阳性的非小细胞肺癌脑转移的疗效。

The effectiveness of EGFR-TKIs against brain metastases in EGFR mutation-positive non-small-cell lung cancer.

作者信息

Bai Hao, Xiong Liwen, Han Baohui

机构信息

Department of Respiratory Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Onco Targets Ther. 2017 Apr 27;10:2335-2340. doi: 10.2147/OTT.S129809. eCollection 2017.

Abstract

Brain metastases are usual in non-small-cell lung cancer (NSCLC) with poor prognosis and few available therapeutic options. This retrospective study aims to evaluate the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) against brain metastases from NSCLC harboring activating mutation. A total of 148 patients with brain metastases from mutation-positive NSCLC were analyzed retrospectively. The patients were orally given gefitinib (250 mg) or erlotinib (150 mg) once a day until intracranial disease progression, death, or intolerable side effects. A survival analysis was done using the Kaplan-Meier analysis and log-rank test. Objective response rate and disease control rate within brain lesions were 36.5% and 87.2%, respectively, with a median progression-free survival (PFS) and overall survival (OS) of 11.2 months (95% confidence interval [CI], 10.1-12.3) and 13.6 months (95% CI, 12.3-14.9), respectively. The patients' characteristics were not statistically associated with PFS and OS. EGFR-TKIs showed promising antitumor activity against brain metastases in NSCLC patients with activating mutation and might be the treatment choice in this clinical setting.

摘要

脑转移在非小细胞肺癌(NSCLC)中很常见,预后较差且可用的治疗选择有限。这项回顾性研究旨在评估表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)对携带激活突变的NSCLC脑转移瘤的疗效。对总共148例来自突变阳性NSCLC的脑转移患者进行了回顾性分析。患者每天口服吉非替尼(250 mg)或厄洛替尼(150 mg)一次,直至颅内疾病进展、死亡或出现无法耐受的副作用。使用Kaplan-Meier分析和对数秩检验进行生存分析。脑内病变的客观缓解率和疾病控制率分别为36.5%和87.2%,中位无进展生存期(PFS)和总生存期(OS)分别为11.2个月(95%置信区间[CI],10.1 - 12.3)和13.6个月(95%CI,12.3 - 14.9)。患者的特征与PFS和OS无统计学关联。EGFR-TKIs对携带激活突变的NSCLC脑转移瘤显示出有前景的抗肿瘤活性,可能是这种临床情况下的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5a14/5415007/86910b55b514/ott-10-2335Fig1.jpg

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