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培美曲塞对表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)耐药的中晚期肺癌患者疗效、毒性反应及生存率的影响

Effect of pemetrexed on the efficacy, toxic reaction, and survival rate of patients with EGFR-TKI resistant moderate and advanced lung cancer.

作者信息

Cao Pingping, Wang Yaoji

机构信息

The First Department of Respiratory Medicine, The First People's Hospital of Wenling Wenling, Zhejiang Province, China.

出版信息

Am J Transl Res. 2021 Jul 15;13(7):7857-7865. eCollection 2021.

Abstract

OBJECTIVE

To explore the effect of pemetrexed on the efficacy, toxic reaction, and survival rate of patients with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) resistant moderate to advanced lung cancer.

METHODS

A total of 86 patients with EGFR-TKI resistant moderate and advanced lung cancer in our hospital were divided by therapeutic drugs into a control group (39 patients) and pemetrexed group (47 patients). Differences in general data, clinical efficacy, immunoglobulin expression, tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) levels, tumor markers, toxic reaction, and survival rate between the two groups were analyzed.

RESULTS

Similar expression levels of carcinoembryonic antigen, IL-6, carbohydrate antigen 125, TNF-α, carbohydrate antigen 153 and immunoglobulin were found in the control group and pemetrexed group before treatment (all P>0.05). Expression levels of the above indicators in all patients decreased one month after the end of treatment, and levels of immunoglobulin, inflammatory factors, and tumor markers in the control group were higher than those in the pemetrexed group (all P<0.05). Similar incidence rates of toxic reactions were shown in the two groups (P>0.05). Twelve months after the end of treatment, one-year survival rate was significantly higher in the pemetrexed group than in the control group (χ=3.332, P=0.042).

CONCLUSION

Pemetrexed can significantly improve the clinical efficacy in patients with EGFR-TKI resistant lung cancer, decrease the expression of inflammatory factors, tumor markers, and immunoglobulin in serum, has few side effects on the body, and prolongs the long-term survival rate.

摘要

目的

探讨培美曲塞对表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)耐药的中晚期肺癌患者疗效、毒副反应及生存率的影响。

方法

将我院86例EGFR-TKI耐药的中晚期肺癌患者按治疗药物分为对照组(39例)和培美曲塞组(47例)。分析两组患者一般资料、临床疗效、免疫球蛋白表达、肿瘤坏死因子α(TNF-α)和白细胞介素-6(IL-6)水平、肿瘤标志物、毒副反应及生存率的差异。

结果

治疗前,对照组和培美曲塞组癌胚抗原、IL-6、糖类抗原125、TNF-α、糖类抗原153及免疫球蛋白表达水平相近(均P>0.05)。所有患者治疗结束1个月后上述指标表达水平均下降,且对照组免疫球蛋白、炎症因子及肿瘤标志物水平高于培美曲塞组(均P<0.05)。两组毒副反应发生率相近(P>0.05)。治疗结束12个月后,培美曲塞组1年生存率显著高于对照组(χ=3.332,P=0.042)。

结论

培美曲塞可显著提高EGFR-TKI耐药肺癌患者的临床疗效,降低血清炎症因子、肿瘤标志物及免疫球蛋白表达,对机体副作用少,并延长长期生存率。

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A New Standard of Care for Advanced Lung Cancer.晚期肺癌的一种新护理标准。
N Engl J Med. 2018 May 31;378(22):2135-2137. doi: 10.1056/NEJMe1804364.

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