甲磺酸阿帕替尼治疗间变性淋巴瘤激酶抑制剂耐药非小细胞肺癌的疗效分析

The efficacy of Apatinib in the treatment of ALK inhibitor-resistant non-small-cell lung cance

目的:评估阿帕替尼联合化疗治疗间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)抑制剂耐药非小细胞肺癌的有效性和安全性。方法:选择我院2018年7月至2019年6月确诊的ALK抑制剂耐药的非小细胞肺癌患者,随机数字表法分组后评估阿帕替尼联合化疗治疗的疗效和毒性,并通过Kaplan-Meier方法进行生存分析。结果:本研究包括30例患者,其中15例接受阿帕替尼联合化疗治疗,另15例接受单纯化疗。所有患者进行了无进展生存期评估,其中联合组中5例患者达到部分缓解(PR),7例达到稳定疾病(SD),缓解率为33.3%,疾病控制率为80.00%,均高于化疗组;中位无进展生存期为3.23月(95%CI:1.589~4.871)。加用阿帕替尼常见不良反应为手足综合征、胃肠反应、肝损伤及高血压,药物毒性等级基本为1~2级。结论:阿帕替尼联合化疗治疗ALK耐药快速进展的非小细胞肺癌,临床效果较为确切,毒性作用和不良反应可耐受,值得在临床中进一步研究。

Objective:To evaluate the efficacy and safety of apatinib combined with chemotherapy in the treatment of ALK inhibitor-resistant non-small-cell lung cancer(NSCLC).Methods:Patients with ALK inhibitory-resistant nonsmall cell lung cancer diagnosed in our hospital from July 2018 to June 2019 were selected.After grouping randomly,to evaluate the efficacy and toxicity of apatinib combined with chemotherapy.Kaplan-Meier was used for survival analysis.Results:A total of 30 cases were selected,15 cases received apatinib combined with chemotherapy and the other 15 cas⁃es received chemotherapy alone.All were assessed for progression-free survival,of which 5 cases in the combination group achieved partial response(PR),7 patients achieved stable disease(SD),a response rate of 33.3%,and a dis⁃ease control rate of 80.00%.The median progression-free survival was 3.23 months(95%CI,1.589-4.871).The com⁃mon adverse reactions of adding apatinib were hand-foot syndrome,gastrointestinal reactions,liver injury and hyperten⁃sion,and the drug toxicity was basically alter grade1 to 2.Conclusion:The clinical effect of apatinib combined with chemotherapy in the treatment of NSCLC with rapid progression of ALK resistance is relatively clear.Toxic effects and adverse reactions are tolerable,which deserves further study clinically.