| Qunhui Wang,Hua Zheng,Ying Hu,Baohua Lu,Fanbin Hu,Hongmei Zhang,Baolan Li. Icotinib, an EGFR-TKI, for the treatment of brain metastases in non-small cell lung cancer: a retrospective study. Oncol Transl Med, 2016, 2: 268-274. |
| 埃克替尼治疗非小细胞肺癌脑转移的51例回顾性分析 |
| Icotinib, an EGFR-TKI, for the treatment of brain metastases in non-small cell lung cancer: a retrospective study |
| Received:October 13, 2016 Revised:December 23, 2016 |
| DOI：10.1007/s10330-016-0198-8 |
| 中文关键词: 非小细胞肺癌，脑转移，埃克替尼，EGFR |
| 英文关键词: non-small cell lung cancer (NSCLC); brain metastases; icotinib; epidermal growth factor receptor (EGFR) |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Qunhui Wang | Department of Oncology,Beijing Chest Hospital,Capital Medical University | qunhui92@sina.com | | Hua Zheng* | Department of Oncology,Beijing Chest Hospital,Capital Medical University | zhenghua022@sina.com | | Ying Hu | Department of Oncology,Beijing Chest Hospital,Capital Medical University | | | Baohua Lu | Department of Oncology,Beijing Chest Hospital,Capital Medical University | | | Fanbin Hu | Department of Oncology,Beijing Chest Hospital,Capital Medical University | | | Hongmei Zhang | Department of Oncology,Beijing Chest Hospital,Capital Medical University | | | Baolan Li | Department of Oncology,Beijing Chest Hospital,Capital Medical University | |
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| 中文摘要: |
| 目的 非小细胞肺癌(Non-small-cell lung cancer, NSCLC)脑转移预后不佳。埃克替尼是我国自主研发一种表皮生长因子受体酪氨酸激酶抑制剂,应用于治疗晚期NSCLC。本研究拟了解埃克替尼治疗NSCLC脑转移的疗效、预后及其相关因素。
方法 回顾性分析51例埃克替尼治疗NSCLC脑转移患者的临床资料,所有患者均口服埃克替尼125mg/,每天3次。使用SPSS软件 17.0进行但因素分析和多因素生存分析。
结果 51例患者中，35例获得部分缓解, 6例患者疾病稳定， 10例患者疾病进展。31例患者进行了EGFR 基因检测，其中26例发现突变，5例为野生型。在突变的患者中，疾病空置率为 88.5%（23例），且比野生型明显多 (1例, DCR 20%) (P = 0.005). 总PFS为7.6个月，且 PFS在突变型比野生型明显长 (7.8月 vs. 1.2 月, P=0.03).中位生存时间（OS）10.7个月；其中EGFR突变型与野生型比较OS（15.1月vs. 6.7月，P＝0.003），均有明显延长。主要不良反应为皮疹、皮肤干燥和腹泻,以1~ 2级为主。单因素分析提示OS与性别、PS、吸烟史和EGFR基因突变状况有关（P<0.05）。多因素分析总生存（OS）与性别、PS评分、EGFR突变状况有关（P<0.05）
结论 埃克替尼对NSCLC脑转移有一定疗效，尤其对EGFR突变型患者，疗效明显，可以作为EGFR突变阳性NSCLC脑转移的患者治疗的新选择。 |
| 英文摘要: |
| Objective Treatment of brain metastases from non-small cell lung cancer (NSCLC) is a challenge
because of the poor prognosis. Icotinib is a new type of oral epidermal growth factor receptor (EGFR)
tyrosine kinase inhibitor (TKI) used in the treatment of advanced NSCLC. The aim of this study was to
evaluate the efficacy of icotinib in NSCLC patients with brain metastasis.
Methods This study reviewed records of 51 NSCLC patients with brain metastases who took icotinib 125
mg, 3 times a day. Response rate, progression free survival, and overall survival were analyzed. SPSS
software version 17.0 was used for univariate analysis, and Cox regression analysis to analyze factors
affecting survival.
Results Thirty-six cases had partial response, 6 cases had stable disease, and 10 cases had progressive
disease. In 31 cases, EGFR gene mutation test were performed. EGFR was mutated in 26 cases and was
with wild-type in 5 cases. In patients with EGFR mutations, 23 patients responded to icotinib [the disease
control rate (DCR) was 88.5%], significantly higher than in patients with wild-type EGFR (1 patient, DCR
20%) (P = 0.005). The overall median progression-free survival (PFS) was 7.6 months. PFS was longer
in the patients with EGFR mutations than in those with wild type EGFR (7.8 months vs 1.2 months, P =
0.03). The overall median overall survival (OS) time was 10.7 months. OS was longer in patients with
EGFR mutations than in those with wild type EGFR (15.1 months vs 6.7 months, P = 0.003). The main
side effects of the treatment were skin rash and diarrhea; no stage 3 or 4 toxic effects occurred. Univariate
analysis demonstrated that OS was related to sex, Eastern Cooperative Oncology Group performance
status (ECOG PS), smoking history, and EGFR mutation. Multivariate analysis showed that OS was
independently related to sex, ECOG PS, and EGFR mutations.
Conclusion Icotinib has a favorable effect on NSCLC patients with brain metastases harboring EGFR
mutations. Icotinib can be a new choice of treatment for brain metastases in patients with NSCLC harboring
EGFR mutations. |
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