Yang Xiao-Bing, Chai Xiao-Shu, Wu Wan-Yin, Long Shun-Qin, Deng Hong, Pan Zong-Qi, He Wen-Feng, Zhou Yu-Shu, Liao Gui-Ya, Xiao Shu-Jing
Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 510120, China.
Chin J Integr Med. 2018 Oct;24(10):734-740. doi: 10.1007/s11655-017-2819-8. Epub 2017 Aug 9.
To evaluate the effect of Fuzheng Kang'ai Formula (, FZKA) plus gefitinib in patients with advanced non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutations.
A randomized controlled trial was conducted from 2009 to 2012 in South China. Seventy chemotherapynaive patients diagnosed with stage IIIB/IV non-small cell lung cancer with EGFR mutations were randomly assigned to GF group [gefitinib (250 mg/day orally) plus FZKA (250 mL, twice per day, orally); 35 cases] or G group (gefitinib 250 mg/day orally; 35 cases) according to the random number table and received treatment until progression of the disease, or development of unacceptable toxicities. The primary endpoint [progression-free survival (PFS)] and secondary endpoints [median survival time (MST), objective response rate (ORR), disease control rate (DCR) and safety] were observed.
No patient was excluded after randomization. GF group had significantly longer PFS and MST compared with the G group, with median PFS of 12.5 months (95% CI 3.30-21.69) vs. 8.4 months (95% CI 6.30-10.50; log-rank P<0.01), MST of 21.5 months (95% CI 17.28-25.73) vs. 18.3 months (95% CI 17.97-18.63; log-rank P<0.01). ORR and DCR in GF group and G group were 65.7% vs. 57.1%, 94.3% vs. 80.0%, respectively (P>0.05). The most common toxic effects in the GF group and G group were rash or acne (42.8% vs. 57.1%, P>0.05), diarrhea (11.5% vs. 31.4%, P<0.05), and stomatitis (2.9% vs. 8.7%, P>0.05).
Patients with advanced non-small cell lung cancer selected by EGFR mutations have longer PFS, MST with less toxicity treated with gefitinib plus FZKA than gefitinib alone.
评估扶正抗癌方(FZKA)联合吉非替尼对晚期表皮生长因子受体(EGFR)突变型非小细胞肺癌患者的疗效。
2009年至2012年在中国南方开展了一项随机对照试验。70例初治的诊断为ⅢB/Ⅳ期EGFR突变型非小细胞肺癌患者,根据随机数字表随机分为GF组[吉非替尼(口服250mg/天)联合FZKA(口服250mL,每日2次);35例]和G组(吉非替尼口服250mg/天;35例),接受治疗直至疾病进展或出现不可接受的毒性反应。观察主要终点[无进展生存期(PFS)]和次要终点[中位生存时间(MST)、客观缓解率(ORR)、疾病控制率(DCR)及安全性]。
随机分组后无患者被排除。GF组的PFS和MST显著长于G组,中位PFS分别为12.5个月(95%CI 3.30 - 21.69)和8.4个月(95%CI 6.30 - 10.50;对数秩检验P<0.01),MST分别为21.5个月(95%CI 17.28 - 25.73)和18.3个月(95%CI 17.97 - 18.63;对数秩检验P<0.01)。GF组和G组的ORR和DCR分别为65.7%对57.1%、94.3%对80.0%(P>0.05)。GF组和G组最常见的毒性反应为皮疹或痤疮(42.8%对57.1%,P>0.05)、腹泻(11.5%对31.4%,P<0.05)和口腔炎(2.9%对8.7%,P>0.05)。
EGFR突变型晚期非小细胞肺癌患者,吉非替尼联合FZKA治疗较单用吉非替尼具有更长的PFS和MST,且毒性更低。