中药延长表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）治疗携带 EGFR 突变的非小细胞肺癌（NSCLC）患者无进展生存期并增强治疗效果。
Traditional Chinese Medicine Prolongs Progression-Free Survival and Enhances Therapeutic Effects in Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI)Treated Non-Small-Cell Lung Cancer (NSCLC) Patients Harboring EGFR Mutations.
机构信息
School of Traditional Chinese Medicine University, Chongqing, China (mainland).
Department of Traditional Chinese Medicine, Chongqing Cancer Hospital, Chongqing University Cancer Hospital, Chongqing, China (mainland).
出版信息
Med Sci Monit. 2019 Nov 9;25:8430-8437. doi: 10.12659/MSM.917251.
BACKGROUND Lung cancer is the most common cause of cancer-associated deaths worldwide. This study aimed to investigate the efficacy and safety of Traditional Chinese Medicine combining EGFR-TKIs in treatment of NSCLC patients harboring EGFR mutations. MATERIAL AND METHODS This study involved 153 advanced-stage NSCLC patients harboring EGFR mutations. Patients were divided into a Control group (administered EGFR-TKI, n=61) and an Experimental group (administered Traditional Chinese Medicine combining EGFR and TKI, n=92). Progression-free survival (PFS) was evaluated for exon 19 deletion and/or 21 deletion patients. Disease control rate (DCR) was assessed to observe therapeutic effects. Adverse effects, including rashes, diarrhea, ALT/AST increase, dental ulcers, and onychia lateralis, were also evaluated. RESULTS TCM combining EGFR-TKI (90.11%) demonstrated no DCR improvement compared to single EGFR-TKI (83.33%) (p>0.05). Median PFS (mPFS) of TCM combining EGFR-TKI (13 months) was significantly longer compared to that in the single EGFR-TKI group (8.8 months) (p=0.001). For 19DEL mutant NSCLC, the mPFS (11 months) in TCM combining EGFR-TKI was significantly longer compared to single EGFR-TKI (8.5 months) (p=0.007). The mPFS of L858 mutant NSCLC patients in EGFR-TKI combining CTM (14 months) was significantly longer compared to single EGFR-TKI (9.5 months) (p=0.015). TCM combining EGFR-TKI was more inclined to prolong mPFS of NSCLC with exon 21 deletion. TCM combining EGFR-TKI illustrated no additional adverse effects in NSCLC patients (p=0.956). CONCLUSIONS Application of Traditional Chinese Medicine prolonged progression-free survival and enhanced therapeutic effect in NSCLC patients harboring EGFR mutations receiving EGFR-TKI treatment. Meanwhile, adjunctive Chinese medicine combining EGFR-TKI in NSCLC with EGFR mutations caused no adverse effects.
背景
肺癌是全球癌症相关死亡的最常见原因。本研究旨在探讨中药联合 EGFR-TKI 治疗 EGFR 突变的 NSCLC 患者的疗效和安全性。
材料与方法
本研究纳入了 153 例晚期 EGFR 突变的 NSCLC 患者。患者分为对照组（给予 EGFR-TKI，n=61）和实验组（给予中药联合 EGFR-TKI，n=92）。对 exon19 缺失和/或 21 缺失的患者进行无进展生存期（PFS）评估。评估疾病控制率（DCR）以观察治疗效果。还评估了不良反应，包括皮疹、腹泻、ALT/AST 升高、口腔溃疡和甲床侧突。
结果
与单独使用 EGFR-TKI 相比，中药联合 EGFR-TKI（90.11%）的 DCR 无改善（p>0.05）。中药联合 EGFR-TKI 组的中位 PFS（mPFS）（13 个月）明显长于单独 EGFR-TKI 组（8.8 个月）（p=0.001）。对于 19DEL 突变的 NSCLC，中药联合 EGFR-TKI 的 mPFS（11 个月）明显长于单独 EGFR-TKI（8.5 个月）（p=0.007）。EGFR-TKI 联合 CTM 治疗 L858 突变 NSCLC 患者的 mPFS（14 个月）明显长于单独 EGFR-TKI（9.5 个月）（p=0.015）。中药联合 EGFR-TKI 更倾向于延长 EGFR-TKI 治疗的 EGFR 突变 NSCLC 的 mPFS。中药联合 EGFR-TKI 治疗 NSCLC 患者无不良反应增加（p=0.956）。
结论
应用中药可延长 EGFR 突变 NSCLC 患者的无进展生存期，增强 EGFR-TKI 治疗的疗效。同时，中药联合 EGFR-TKI 治疗 EGFR 突变的 NSCLC 不会引起不良反应。
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