奥希替尼联合贝伐珠单抗治疗14例EGFR突变型肺腺癌脑转移的疗效观察

Clinical efficacy of osimertinib and bevacizumab combination in 14 patients with EGFRmutant lung adenocarcinoma brain metastases

目的:观察和评估奥希替尼联合贝伐珠单抗治疗14例EGFR突变型肺腺癌脑转移患者的疗效及安全性。方法:回顾性分析2017年1月至2019年12月广州市胸科医院收治的伴有EGFR突变的肺腺癌脑转移患者共14例,所有患者均给予奥希替尼及贝伐珠单抗联合治疗,每3周为1个周期,观察其脑转移病灶疗效并评估不良反应。结果:14例患者中11例(78.6%)脑转移病灶为部分缓解,2例疾病稳定(14.3%),1例疾病进展(7.1%),客观缓解率为78.6%(11/14),疾病控制率为92.9%(13/14)。颅内中位无进展生存期(median progression-free survival,mPFS)为12.5个月(95%CI:8.53~15.87)。最常出现的不良反应为贫血(57.1%)、高血压(50.5%)以及蛋白尿(28.6%),未出现因不良反应停药事件发生。结论:奥希替尼联合贝伐珠单抗治疗EGFR突变型肺腺癌脑转移疗效较好,不良反应可控,但仍需大样本临床试验进一步验证。

Objective:To evaluate the efficacy and safety of osimertinib and bevacizumab combination therapy for brain metastases in 14 patients with epidermal growth factor receptor(EGFR)-mutant lung adenocarcinoma.Methods:The clinical data of 14 patients with EGFR-mutant lung adenocarcinoma brain metastases treated at the Guangzhou Chest Hospital from January 2017 to December 2019 were retrospectively analyzed.They received a combination of osimertinib and bevacizumab treatment,repeated every 3 weeks,and were observed for drug efficacy and adverse reactions.Results:Among the 14 patients,11(78.6%)achieved partial response in their brain metastases,two(14.3%)had stable disease,and one(7.1%)had progressive disease.The objective response rate was 78.6%(11/14),the disease control rate was 92.9%(13/14),and the median progression-free survival(mPFS)was 12.5 months(95%CI:8.53~15.87).The most common adverse events noted were anemia(57.1%),hypertension(50.5%),and proteinuria(28.6%).No patient discontinued treatment due to adverse reactions.Conclusions:The clinical efficacy of osimertinib and bevacizumab combination treatment for EGFR-mutant lung adenocarcinoma brain metastases looks promising,and it seems that adverse reactions can be controlled;however,clinical analysis of a larger series of samples is needed.