文章摘要

EGFR-TKI治疗表皮生长因子受体野生型晚期肺腺癌1例并文献复习

作者: 1李梦远, 1华陈, 1罗建华, 1潘君素
1 台州市立医院呼吸内科,浙江 台州 31800
通讯: 李梦远 Email: 493486829@qq.com
DOI: 10.3978/j.issn.2095-6959.2019.12.041

摘要

报告1例表皮生长因子受体(epidermal growth factor receptor,EGFR)野生型晚期肺腺癌患者的相关临床资料,复习相关文献。患者,女,64岁,不吸烟,因反复头痛1个月于当地医院就诊。胸部CT提示右上肺占位。头颅MR提示脑内多发病灶,考虑转移。肺穿刺病理提示肺腺癌,血浆表皮生长因子受体野生型。因该患者拒绝放化疗,予埃克替尼靶向治疗,无进展生存期14个月。继发耐药后,组织二代测序示exon20.pT790M突变,予以奥希替尼二线治疗,疗效佳。对于无法获得组织标本或者血浆EGFR检测阴性的不吸烟亚洲女性肺腺癌患者,在放化疗失败或不适宜放化疗的患者中,可尝试EGFR-TKIs靶向治疗,部分患者可从中获益。
关键词: 靶向治疗;肺腺癌;表皮生长因子受体;野生型

Tyrosine kinase inhibitor in the treatment of advanced lung adenocarcinoma with EGFR wild-type: A case report and literature review

Authors: 1LI Mengyuan, 1HUA Chen, 1LUO Jianhua, 1PAN Junsu
1 Department of Respiratory Medicine, Taizhou Municipal Hospital, Taizhou Zhejiang 318000, China

CorrespondingAuthor: LI Mengyuan Email: 493486829@qq.com

DOI: 10.3978/j.issn.2095-6959.2019.12.041

Abstract

We report a case of epidermal growth factor receptor (EGFR) wild-type advanced lung adenocarcinoma and review relevant literature. A 64-year-old female non-smoker was treated in a local hospital for no obvious cause of headache for 1 month. Chest CT showed a tumor in the right upper lung. Brain MR suggested multiple lesions in the brain, considering metastasis. Lung biopsy in our hospital indicated lung adenocarcinoma, plasma EGFR mutation test is negative. Because the patient refused to receive radiotherapy and chemotherapy, she was started on icotinib, progressive-free survival 14 months. After the front-line treatment failed, tumor tissue exon 20.pT790M mutation appeared. Third-denervation TKI Osimertinib was started and effective. For non-smoking Asian women with lung adenocarcinoma who cannot obtain tissue specimens or have negative EGFR mutation in plasma, targeted EGFR-TKIs therapy can be tried in patients who fail or are unsuitable for radiotherapy and chemotherapy, and some patients of those can benefit from it.
Keywords: targeted therapy; adenocarcinoma of lung; epidermal growth factor receptor; wildtype