Xiao Chunmei, Xu Fangye, Wang Rong, Liang Qi, Shen Kai, Xu Jiali, Liu Lianke
Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People's Republic of China.
Onco Targets Ther. 2021 Dec 1;14:5363-5372. doi: 10.2147/OTT.S335139. eCollection 2021.
Ovarian cancer (OC) is a common malignancy in the gynecological tumor. Standard treatment for ovarian cancer is surgery and chemotherapy based on paclitaxel and platinum. However, traditional chemotherapy for ovarian cancer is limited by drug resistance and systemic side effects. It is imperative to explore effective treatment options for refractory ovarian cancer.
A 52-year-old female initially presented with lower abdominal distension and migratory pain. After the laparoscopic exploration and biopsy, immunohistochemistry showed poorly differentiated adenocarcinoma originated from ovarian (cT3NxM1, stage IV, peritoneal and abdominal wall metastasis). The next generation sequence detected ERRFI1 (T187A, exon4) mutation.
The patient received first-line chemotherapy (paclitaxel, nedaplatin plus avastin), followed by maintenance therapy with gefitinib, achieving a 15-month progression-free survival (PFS). After disease progression and second-line treatment failure, endostar plus apatinib was administered for 14 cycles and she obtained a PFS of 14 months without long-term adverse events.
We believe that the ERRFI1 gene may be a potential target of gefitinib. Importantly, endostar combined with apatinib is worth recommending for maintenance treatment in refractory ovarian cancer.
卵巢癌（OC）是妇科肿瘤中常见的恶性肿瘤。卵巢癌的标准治疗方法是手术及以紫杉醇和铂类为基础的化疗。然而，卵巢癌的传统化疗受到耐药性和全身副作用的限制。探索难治性卵巢癌的有效治疗方案势在必行。
一名52岁女性最初表现为下腹胀和游走性疼痛。经腹腔镜探查及活检，免疫组化显示为起源于卵巢的低分化腺癌（cT3NxM1，IV期，腹膜及腹壁转移）。二代测序检测到ERRFI1（T187A，外显子4）突变。
患者接受一线化疗（紫杉醇、奈达铂加阿瓦斯汀），随后用吉非替尼维持治疗，实现了15个月的无进展生存期（PFS）。疾病进展且二线治疗失败后，给予恩度加阿帕替尼治疗14个周期，她获得了14个月的PFS且无长期不良事件。
我们认为ERRFI1基因可能是吉非替尼的潜在靶点。重要的是，恩度联合阿帕替尼值得推荐用于难治性卵巢癌的维持治疗。
