文章摘要

阿帕替尼治疗晚期非小细胞肺癌的疗效

作者: 1石明伟, 2王升晔, 3徐振武, 3庄武, 3黄韵坚, 3吴标, 4朱有才, 5许春伟, 6徐倩
1 中国科学院合肥肿瘤医院肿瘤科,合肥 230031
2 浙江省肿瘤医院放疗科,杭州 310022
3 福建医科大学附属福建省肿瘤医院胸部肿瘤内科,福州 350014
4 浙江省荣军医院胸部疾病中心,浙江 嘉兴 314000
5 福建医科大学附属福建省肿瘤医院病理科,福州 350014
6 福建医科大学附属协和医院肿瘤科,福州 350014
通讯: 王升晔 Email: joycewang04@163.com
DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2017.09.019
基金: 国家临床重点专科建设项目, 2013 浙江省科技厅公益类科研计划, 2015C33194 福建省科技厅引导性项目 2016Y0019, 2015Y0011

摘要

目的:探讨阿帕替尼在晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)中的治疗效果。方法:选取2015年1月至2016年3月于各成员单位收治的72例晚期NSCLC患者纳入研究对象,给予患者口服阿帕替尼,500 mg/次,1次/d,治疗至肿瘤进展、患者死亡或者出现药物毒性不耐受为止。随访并观察患者客观缓解率(objective response rate,ORR)、疾病控制率(disease control rate,DCR)、无进展生存期(progression-free survival,PFS)和毒副反应发生情况。采用单因素分析比较不同临床特征与PFS的关系。结果:患者中位PFS为4.8个月(95%CI 4.7~5.0)。单因素分析显示不同性别、年龄、活动状态(performance status,PS)评分、组织学类型、驱动基因突变情况、有无转移灶、转移灶数量、转移部位、治疗史、治疗线数和病程的患者PFS差异均无统计学意义(P>0.05)。患者ORR为13.89%,DCR为83.33%。疗效瀑布图显示有54例患者病灶缩小,以肿瘤病灶直径减少30%作为治疗有效标准,则有10例患者表现为部分缓解(partial response,PR)。有60例(83.33%)患者发生各类不良事件,其中22例(30.55%)≥III级。结论:阿帕替尼治疗晚期NSCLC疗效显著,安全性高,可在临床进行更加深入的研究和应用。
关键词: 晚期非小细胞肺癌 阿帕替尼 不良事件

Effect of apatinib on the advanced non-small cell lung cancer

Authors: 1SHI Mingwei, 2WANG Shengye, 3XU Zhenwu, 3ZHUANG Wu, 3HUANG Yunjian, 3WU Biao, 4ZHU Youcai, 5XU Chunwei, 6XU Qian
1 Department of Oncology, Cancer Hospital, Chinese Academy of Sciences, Hefei 230031
2 Department Radiotherapy, Zhejiang Cancer Hospital, Hangzhou 310022
3 Department of Thoracic Oncology, Fujian Cancer Hospital, Fujian Medical University, Fuzhou 350014
4 Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing Zhejiang 314000
5 Department of Pathology, Fujian Cancer Hospital, Fujian Medical University, Fuzhou 350014
6 Department of Oncology, Fujian Union Hospital Affiliated Fujian Medical University, Fuzhou 350014, China

CorrespondingAuthor: WANG Shengye Email: joycewang04@163.com

DOI: 10.3978/j.issn.2095-6959.10.3978/j.issn.2095-6959.2017.09.019

Abstract

Objective: To investigate the effect of apatinib in advanced non-small cell lung cancer (NSCLC). Methods: A total of 72 patients with advanced NSCLC treated in our hospital from March 2015 to March 2016 were selected and given oral apatinib (750 mg, qd) to tumor progression, death or toxicity intolerance so far. The objective response rate (ORR), disease control rate (DCR), progression free survival (PFS), and toxic side effects were observed and observed. Single factor analysis was used to compare the relationship between the clinical features and PFS. Results: The median PFS of the patients was 4.8 months (95% CI 4.7–5.0). The single factor analysis showed that there were no significant differences between different gender, age, PS score, histological type, drive gene mutation and metastasis foci, the number of metastasis, metastasis, treatment history, line number and duration of treatment in patients with PFS (P>0.05). The ORR of the patients was 13.89%, and the DCR was 83.33%. The curative effect waterfall map showed that 54 patients have reduced lesions, and the diameter of tumor lesions was reduced by 30%, which was the effective standard for treatment, while 10 patients showed partial response (PR). There were various types of adverse events occurred in 60 patients (83.33%), including 22 cases (30.55%) for the III grade. Conclusions: Apatinib is effective and safe in the treatment of advanced non-small cell lung cancer, which can be carried out more in-depth research and application in clinic.
Keywords: advanced non-small cell lung cancer apatinib adverse event