Department of Thoracic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Thorac Cancer. 2018 May;9(5):656-661. doi: 10.1111/1759-7714.12624. Epub 2018 Mar 24.
Multi-targeted agents represent the next generation of targeted therapies for solid tumors, and patients with acquired resistance to EGFR-tyrosine kinase inhibitors (TKIs) may also benefit from their combination with TKI therapy. Third-generation targeted drugs, such as osimertinib, are very expensive, thus a more economical solution is required. The aim of this study was to explore the use of apatinib combined with icotinib therapy for primary acquired resistance to icotinib in three patients with advanced pulmonary adenocarcinoma with EGFR mutations. We achieved favorable oncologic outcomes in all three patients, with progression-free survival of four to six months. Unfortunately, the patients ultimately had to cease combination therapy because of intolerable adverse effects of hand and foot syndrome and oral ulcers. Combination therapy of apatinib with icotinib for primary acquired resistance to icotinib may be an option for patients with advanced pulmonary adenocarcinoma with EGFR mutations, but physicians must also be aware of the side effects caused by such therapy.
多靶点药物代表了实体肿瘤靶向治疗的下一代，而对 EGFR-酪氨酸激酶抑制剂（TKI）产生获得性耐药的患者也可能从与 TKI 治疗联合中受益。第三代靶向药物，如奥希替尼，非常昂贵，因此需要更经济的解决方案。本研究旨在探讨阿帕替尼联合厄洛替尼治疗 3 例晚期肺腺癌 EGFR 突变患者对厄洛替尼原发性获得性耐药的疗效。我们在所有 3 例患者中均取得了良好的肿瘤学疗效，无进展生存期为 4 至 6 个月。不幸的是，由于手足综合征和口腔溃疡的不可耐受的不良反应，患者最终不得不停止联合治疗。阿帕替尼联合厄洛替尼治疗厄洛替尼原发性获得性耐药可能是 EGFR 突变晚期肺腺癌患者的一种选择，但医生也必须注意这种治疗引起的副作用。
