SELDI蛋白质指纹对因基因多态性导致耐药性漂移诊断的前瞻性研究——吉非替尼与含铂方案序贯治疗非小细胞肺癌

Prospective Study on Surface-enhanced Laser Desorption/Ionization Protein Fingerprinting for Diagnosing Gene Polymorphism Leading to Drug Resistance Drift:Sequential Therapy with a Platinum-based Regimen and Gefitinib for Non-small Cell Lung Cancer

背景与目的本研究组前期研究发现借助于SELDI技术可以预测吉非替尼的疗效,而且指出其蛋白质指纹图谱M/Z:8,693±50H+丰度25%,可以作为吉非替尼治疗非小细胞肺癌(non-smallcelllungcancer,NSCLC)患者取、舍的筛选指标,以这个指标为界定,观察含铂方案治疗失败的患者以蛋白质指纹为依据指导化疗与吉非替尼的序贯应用的方法的远期效果。方法选择TP、DP和GP方案化疗失败,且经SELDI检测M/Z(质核比)8,693±50H+的丰度15%的NSCLC患者9例,口服吉非替尼250mg,1次/d,治疗期间每2个月查患者血清SELDI指纹,以M/Z:8,693±50H+的丰度>25%作为再化疗指标,并以M/Z:8,693±50H+丰度15%为继续服用吉非替尼的指标,两者之间根据肿块变化和肿瘤标记物变化决定取舍吉非替尼治疗时间,指导吉非替尼与含铂方案的序贯治疗,观察总生存时间。结果随访至2010年12月,9例患者中位总生存期为27个月(10个月-66个月)。结论 SELDI技术通过指纹的描述,有计划地选择这些抗肿瘤药物治疗NSCLC的取、舍,可提高药物治疗的获益率和获益时间。

[ Abstract ] Background and objective This study aims to observe the long-term effects of sequential therapy with a platinum-based regimen and gefitinib for non-small cell lung carcinoma （NSCLC） with failed chemotherapy under the guid- ance of surface-enhanced laser desorption/ionization （SELDI）. Methods Nine NSCLC patients with failed chemotherapy and 〈15% abundance of M/Z： 8,693±50H＋ were selected. ＂ihe patients were administered with 250 mg of gefitinib （p.o., once a day）.