阿美替尼和伏美替尼在晚期NSCLC患者EGFR突变的近远期效果比较

Comparison of Short-term and Long-term Effects of Almonertinib and Furmonertinib on EGFR Mutations in Advanced NSCLC Patients

目的将阿美替尼和伏美替尼用于治疗晚期非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)突变中,比较两者近远期效果。方法以2021年4月至2022年4月为期,本院共收治晚期NSCLC EGFR突变患者64例,均纳入本研究,根据随机数字表法将其分为A组和B组,各32例。A组给予阿美替尼治疗,B组给予伏美替尼治疗。比较两组患者近远期效果、血清肿瘤标志物、不良反应发生率以及血管生长因子水平。结果A组客观缓解率(ORR)、不良反应发生率与B组比较,均无统计学意义(P>0.05);B组中位无进展生存期(PFS)和总生存期(OS)均长于A组(P<0.05);与治疗前比较,两组血小板衍生生长因子(PDGF)、血管内皮生长因子(VEGF)、碱性成纤维细胞生长因子(bFGF)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)水平在服药2个月后均降低(P<0.05),但B组上述指标与A组比较差异无统计学意义(P>0.05)。结论阿美替尼和伏美替尼治疗晚期NSCLC患者EGFR突变近期疗效与安全性相当,且在下调肿瘤标志物和血管生长因子方面的作用相近,但相较而言,伏美替尼更有助于患者生存期的延长。

Objective To explore and compare the short-term and long-term effects of almonertinib and furmonertinib on epidermal growth factor receptor(EGFR)mutations in patients with advanced non-small cell lung cancer(NSCLC).Method From April 2021 to April 2022,a total of 64 patients with EGFR mutation in advanced NSCLC were enrolled in this study.According to the random number table method,they were divided into the group A and the group B,32 cases in each group.The group A was treated with almonertinib,while the group B was treated with furmonertinib.The short-term and long-term effects,serum tumor markers,vascular growth factors levels and incidence of adverse reactions were compared between the two groups.Results There was no significant difference in the objective response rate(ORR)between the group A and incidence of adverse reactions between the group B(P>0.05).The median progression-free survival(PFS)and overall survival(OS)in the group B were longer than those in the group A(P<0.05).The levels ofplatelet-derived growth factor(PDGF),cytokeratin 19 fragment(CYFRA21-1),vascular endothelial growth factor(VEGF),carcinoembryonic antigen(CEA)and basic fibroblast growth factor(bFGF)in the two groups after 2 months of treatment were lower than those before treatment(P<0.05),but there was no statistically significant difference in the above indexes between group B and group A(P>0.05).Conclusion The short-term efficacy and safety of almonertinib and flmonertinib in the treatment of EGFR mutations in patients with advanced NSCLC are comparable,and their effects on down-regulating tumor markers and vascular growth factors are similar.However,furmonertinib is more helpful to prolong the survival of patients.