吉非替尼更换为盐酸埃克替尼成功治疗晚期非小细胞肺癌1例分享

Successful treatment of one patient with advanced non-small cell lung cancer with icotinib hydrochloride in replacement of gefitinib

表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)不良反应以皮疹、腹泻为主,吉非替尼(易瑞沙)和厄洛替尼分别于2005年和2007年在中国上市并获得了良好的疗效,但是仍然有部分可能获益的患者因不良反应而不能接受EGFR-TKI的治疗。盐酸埃克替尼(凯美纳)是我国研制的、具有完全自主知识产权的、高效特异性EGFR-TKI。本病例服用吉非替尼后出现Ⅲ～Ⅳ度腹泻,应用止泻药无效,患者因无法耐受停药。患者改用盐酸埃克替尼口服至今共7个月,未见明显不良反应,用药后1个月疗效评估:病情稳定(SD),体能状况、生活质量得到改善。说明盐酸埃克替尼治疗晚期非小细胞肺癌(NSCLC)具有较好的有效性、安全性和耐受性,与吉非替尼、厄洛替尼相比,疗效较优且不良反应较少。

Common adverse reactions of epidermal growth factor receptor tyrosine kinase inhibitor（EGFRTKI） due to drug toxicity are rash and diarrhea.Positive curative effect has been observed after gefitinib（Iressa,ZD1839） and erlotinib（Tarceva,Ro50-8231） were introduced into China in 2005 and 2007,respectively.However,some patients who were likely to benefit from the therapy might not accept EGFR-TKIs because of severe adverse event（AE） during the treatment.Conmana（icotinib hydrochloride,BPI-2009H） is a newly developed and highly specific EGFR-TKI that is designed in China with independent intellectual property right.In this case,the patient experienced III ～ IV-level diarrhea after taking gefitinib,and antidiarrheal drugs were ineffective.The intolerable AE led to drug withdrawal.Treatment was then transformed into icotinib therapy and had been on for 7 months without apparent AE observed.After the first cycle of icotinib（30 days）,objective responses were evaluated to be SD,physical conditions and the quality of life were improved.This suggests that icotinib is effective and well-tolerated in advanced NSCLC patients,and superior to gefitinib and erlotinib in terms of curative effectiveness and safety among Chinese patients.