奥希替尼治疗晚期T790M突变肺腺癌患者疗效分析

Effect of osimertinib on T790M-postive advanced lung adenocarcinoma

目的探讨奥希替尼在治疗晚期T790M突变肺腺癌患者中的疗效及安全性。方法 T790M突变且既往一线靶向治疗失败的晚期肺腺癌患者64例,分为化疗组22例和奥希替尼组42例,化疗组采用培美曲塞联合卡铂化疗,奥希替尼组口服奥希替尼治疗,分析2组治疗效果及不良反应发生情况。结果奥希替尼组疾病控制率(88.1%)、6个月生存率(78.6%)和1 a生存率(54.8%)明显高于化疗组(68.2%、45.5%、27.3%)(P<0.05);奥希替尼组3级以上不良反应发生率(26.2%)低于化疗组(59.1%)(P<0.05),总不良反应发生率(92.8%)与化疗组(100.0%)比较差异无统计学意义(P>0.05)。结论既往一代靶向治疗失败的晚期肺腺癌患者应行T790M检测,奥希替尼治疗T790M突变患者的疗效及安全性均优于联合化疗。

Objective To evaluate the efficacy and safety of osimertinib in the treatment of T790 M-positive advanced lung adenocarcinoma. Methods Sixty-four patients failed in first-line targeted therapy of T790 M-positive advanced lung adenocarcinoma were divided into 42 patients receiving oral administration of osimertinib(osimertinib group) and 22 patients receiving pemetrexed and carboplation(chemotherapy group). The therapeutic effect and adverse reaction were analyzed in two groups. Results The disease control rate, 6-month survival rate and 1-year survival rate were significantly higher in osimertinib group(88.1%, 78.6%, 54.8%) than those in chemotherapy group(68.2%, 45.5%, 27.3%)(P<0.05). The incidence of >3 grade adverse reaction was significantly lower in osimertinib group(26.2%) than that in chemotherapy group(59.1%)(P<0.05), and there was no significant difference in the overall rate of adverse reaction between osimertinib group(92.8%) and chemotherapy group(100.0%)(P>0.05). Conclusion The patients failed in first-line targeted therapy should be performed T790 M detection. Osimertinib is more effective and safe than chemotherapy.