培美曲塞联合吉非替尼治疗EGFR-TKI二线治疗失败非小细胞肺癌的疗效

The effect of pemetrexed combined with gefitinib in the treatment of advanced NSCLC with second-line treatment of EGFR-TKI

目的:探讨培美曲塞联合吉非替尼继续治疗表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKI)二线治疗失败的非小细胞肺癌(NSCLC)患者的疗效及安全性。方法:对接受EGFR-TKI(厄洛替尼/吉非替尼)二线治疗失败的Ⅲb/Ⅳ期28例NSCLC患者,以培美曲塞联合吉非替尼继续治疗:培美曲塞500 mg/m2d1,吉非替尼250 mg/d,21 d为1周期,治疗至进展。结果:中位随访时间12.4个月,28例中有1例不可评价疗效,其余患者中完全缓解率为0.0%、部分缓解37.0%、疾病稳定44.4%、疾病进展18.5%;疾病控制率为81.5%,总体有效率为37.0%;中位无疾病进展时间和中位生存时间分别为7.0个月和13.6个月;1年无肿瘤进展生存率和1年生存率分别为33.3%和55.6%。Ⅲ度以上皮疹的发生率为14.3%。结论:培美曲塞联合吉非替尼继续治疗EGFR-TKI二线治疗失败的NSCLC疗效良好,且耐受可。

Objective： To investigate the effects and safety of pemetrexed combined with gefitinib in the treatment of patients with advanced non-small-cell lung cancer（NSCLC） with second-line treatment of epidermal growth factor receptor-tyrosine kinase inhibitor（EGFR-TKI）.Methods： Twenty-eight patients with stage Ⅲb/Ⅳ NSCLC treated with second-line treatment of EGFR-TKI（gefitinib/ erlotinib） were treated with 500 mg / m2 of pemetrexed and 250 mg of gefitinib per day（21 days each cycle） until these cases were improved.Results： The median follow-up time was 12.4 months,except 1 case without evaluation,complete response in 0.0%,partial response in 37.0%,stabilization of the disease in 44.4% and progression of disease in 18.5% were found.The disease control and total effective rates were 81.5% and 37.0%,respectively.The time of median without disease progression and survival time were 7.0 months and 13.6 months,respectively.No tumor progression and survival rate of 1 year were 33.3% and 55.6%,respectively.The occurrence rate of skin rash with more grade Ⅲ was 14.3%.Conclusions： The effects and tolerance of pemetrexed combined with gefitinib in the treatment of patients with advanced NSCLC with second-line treatment of EGFR-TKI are good.