Response to osimertinib in a colorectal cancer patient with an EGFR T790M mutation: A case report

BACKGROUND Although common in lung cancer,somatic epidermal growth factor receptor(EGFR)mutations are rarely found in colorectal cancer,occurring in approximately 3%of cases.Treatment with anti-EGFR antibodies is commonplace,but EGFR tyrosine kinase inhibitors are not standard treatments in colorectal cancer.Here we report a case of sustained response to osimertinib in a colorectal cancer patient with an EGFR T790M mutation on cell-free DNA analysis.CASE SUMMARY A 72-year old woman with a past medical history of post-polio syndrome confined to a wheelchair,scoliosis and hypothyroidism presented with metastatic sigmoid colon adenocarcinoma with hepatic metastases.Next generation sequencing revealed a RAS/RAF wild-type,microsatellite stable,PD-L1 negative malignancy.Mutations in TP3 and APC were also identified,as well as EGFR amplification.Cell-free DNA analysis revealed an EGFR T790M mutation.She was unable to tolerate first-line treatment with panitumumab,5-fluorouracil and leucovorin,progressed on second-line treatment with trifluridine/tipiracil plus bevacizumab,and was unable to tolerate third-line treatment with regorafenib.She was started on fourth-line treatment with off-label osimertinib,with clinical response–decrease in size of hepatic metastases and a pericardial effusion.She remained on treatment with osimertinib for seven months.CONCLUSION This case shows the benefit of multi-gene sequencing assays to identify potential therapeutic options in patients with refractory disease.

Osimertinib联合二甲双胍对非小细胞肺癌PC 9/GR细胞的协同效应

目的研究Osimertinib联合二甲双胍对吉非替尼获得性耐药的非小细胞肺癌PC 9/GR细胞的生长抑制效应及其可能机制。方法 Osimertinib和二甲双胍单药或联合作用于PC 9/GR细胞后,应用MTT法检测不同药物处理组处理后对PC 9/GR细胞的抑制率影响;荧光染色法观察和流式细胞术检测Osimertinib和二甲双胍单药或联合诱导细胞凋亡的变化;Western blot法检测各药物处理组细胞磷酸化及非磷酸化的AMP依赖的蛋白激酶(AMPK)和70 ku核糖体蛋白S6激酶(P70S6K)蛋白的表达水平。结果 Osimertinib和二甲双胍双药联合作用可显著抑制PC 9/GR细胞的增殖,作用强于各单药(P<0.05),表现为协同作用(联合指数<1);双药联合时相较于单药表现出更强的诱导细胞凋亡的作用;二甲双胍可上调细胞内p-AMPK蛋白的表达,Osimertinib和二甲双胍均可下调p-P70S6K蛋白,且双药联合较单药下调p-P70S6K蛋白水平更为显著。结论 Osimertinib和二甲双胍联合用药对PC 9/GR细胞的增殖有显著抑制作用并可以促进其凋亡的发生,具有协同作用。

Significant benefits of osimertinib in treating acquired resistance to first-generation EGFR-TKIs in lung squamous cell cancer: A case report

BACKGROUND Lung squamous cell cancer(LSCC)rarely harbors epidermal growth factor receptor(EGFR)mutations,even much rarer for acquired T790M mutation.Although clinical trials of AURA series illustrated that non-small cell lung cancer(NSCLC)with EGFR T790M mutation can benefit from osimertinib,only five LSCC patients were enrolled in total;moreover,the efficacy for LSCC was not shown in the results.Therefore,the response of LSCC to osimertinib is still unclear to date.CASE SUMMARY We report an LSCC case with T790M-related acquired resistance after treatments with first-generation EGFR-tyrosine kinase inhibitors(EGFR-TKIs)and benefited from osimertinib significantly.A 63-year-old Chinese man was diagnosed with stage IV(cT2N2M1b)LSCC harboring an EGFR exon 19-deletion mutation.Following disease progression after gefitinib and multi-line chemotherapy,rebiopsy was conducted.Molecular testing of EGFR by amplification refractory mutation system-polymerase chain reaction detected the exon 19-deletion without T790M mutation.Therefore,the patient was given erlotinib,but progression developed only 3 mo later.Then the frozen re-biopsy tissue was tested by next-generation sequencing(NGS),which detected an EGFR T790M mutation.However,he was very weak with symptoms of dysphagia and cachexia.Fortunately,osimertinib was started,leading to alleviation from the symptoms.Four months later,normal deglutition was restored and partial response was achieved.Finally,the patient achieved an overall survival time period of 29 mo.CONCLUSION Our findings highlight that EGFR T790M mutation may also be an important acquired drug resistance mechanism for LSCC and offer direct evidence of the efficacy of osimertinib in LSCC with T790M mutation.NGS and better preservation conditions may contribute to higher sensitivity of EGFR T790M detection.

Early detection of circulating tumor DNA and successful treatment with osimertinib in thr790met-positive leptomeningeal metastatic lung cancer:A case report

BACKGROUND Patients diagnosed with non-small-cell lung cancer with activated epidermal growth factor receptor mutations are more likely to develop leptomeningeal(LM)metastasis than other types of lung cancers and have a poor prognosis.Early diagnosis and effective treatment of leptomeningeal carcinoma can improve the prognosis.CASE SUMMARY A 55-year-old female with a progressive headache and vomiting for one month was admitted to Peking University First Hospital.She was diagnosed with lung adenocarcinoma with osseous metastasis 10 months prior to admittance.epidermal growth factor receptor(EGFR)mutation was detected by genomic examination,so she was first treated with gefitinib for 10 months before acquiring resistance.Cell-free cerebrospinal fluid(CSF)circulating tumor DNA detection by next-generation sequencing was conducted and indicated the EGFR-Thr790Met mutation,while biopsy and cytology from the patient’s CSF and the first enhanced cranial magnetic resonance imaging(MRI)showed no positive findings.A month later,the enhanced MRI showed linear leptomeningeal enhancement,and the cytology and biochemical examination in CSF remained negative.Therefore,osimertinib(80 mg/d)was initiated as a second-line treatment,resulting in a good response within a month.CONCLUSION This report suggests clinical benefit of osimertinib in LM patients with positive detection of the EGFR-Thr790Met mutation in CSF and proposes that the positive findings of CSF circulating tumor DNA as a liquid biopsy technology based on the detection of cancer-associated gene mutations may appear earlier than the imaging and CSF findings and may thus be helpful for therapy.Moreover,the routine screening of chest CT with the novel coronavirus may provide unexpected benefits。

Triple administration of osimertinib followed by chemotherapy for advanced lung adenocarcinoma: A case report

BACKGROUND Osimertinib is the recommended first-line treatment for adult patients with epidermal growth factor receptor(EGFR)mutation positive advanced or metastatic non-small cell lung cancer(NSCLC).However,primary or acquired resistance to EGFR-tyrosine kinase inhibitors(EGFR-TKIs)seems inevitable,and when drug-resistance occurs during treatment with osimertinib,the standard of care is to discontinue the TKI.CASE SUMMARY A 57-year-old female patient with lung adenocarcinoma presented with an irritating cough accompanied by chest distress of one month duration.An enhanced head magnetic resonance imaging scan showed brain metastases.An EGFR mutation(exon 21 L858R)was detected in pleural fluid.The patient was treated with oral osimertinib(80 mg once daily)from January 2018 but developed progressive disease on December 2018.She was then successfully treated with rechallenge and tri-challenge with osimertinib(80 mg once daily)by resensitization chemotherapy twice after the occurrence of drug-resistance to osimertinib,and to date has survived for 31 mo.CONCLUSION This case may provide some selective therapeutic options for NSCLC patients with acquired drug-resistance who were previously controlled on osimertinib treatment.

Non-small-cell lung cancer with epidermal growth factor receptor L861Q-L833F compound mutation benefits from both afatinib and osimertinib: A case report

BACKGROUND Epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(TKIs)have been adopted as the standard of care for non-small cell lung cancer(NSCLC)patients harboring EGFR sensitizing mutations.Besides the two common mutations exon 19 deletion and L858R,which together comprise approximately 85%of EGFR mutations in NSCLC,rare EGFR mutations also exist,including point mutations,deletions,and insertions spanning EGFR exons 18-25.However,the responsiveness of uncommon EGFR mutations to EGFR TKIs remains elusive and attracts increasing interest.CASE SUMMARY Herein,we report a 55-year-old male patient with stage IV NSCLC harboring a rare EGFR L833F-L861Q compound mutation in cis.The patient achieved a partial response to first-line treatment with afatinib and a progression-free survival of 10 mo.After afatinib failure,the patient received multiple line treatments with chemotherapy.Upon disease progression,the heavily pretreated patient was treated with osimertinib and bevacizumab,and both lung lesion and brain metastases were stable for more than 3 mo.He had an overall survival of 25 mo.CONCLUSION Our case revealed that both afatinib and the osimertinib+bevacizumab combination demonstrated clinical efficacy in NSCLC harboring an EGFR L833FL861Q compound mutation.The results provide more therapeutic options for patients with rare compound mutations.

Separation, Identification, Isolation and Characterization of Degradation Product of Osimertinib Tablets by UPLC-QTOF-MS/MS and NMR: Evaluation of <i>In-Silico</i>Safety Assessment for Osimertinib (OSM) and Degradation Product (DP)

The present work encompasses identification and characterization of major degradation product (DP) of OSM observed in base hydrolytic stress study. The separation of DP was carried out on a non-polar stationary phase by using high-performance liquid chromatography system (HPLC). Using waters X-bridge (250 mm × 4.6 mm, 5 μm) C18 column with gradient elution program. For the characterization study, stress samples were subjected to HPLC and UPLC-QTOF-MS/MS and based on mass fragmentation pattern, plausible structure was deduced. Further, the DP was isolated using semi-prepara- tive liquid chromatography and concentrated the fractions using lyophilization. The isolated DP was subjected to extensive 1D (1H, 13C, and DEPT-135) and 2D (COSY, HSQC and HMBC) nuclear magnetic resonance (NMR) studies to authenticate the structure. The impurity was unambiguously named as N-(2-((2-(dimethylamino)ethyl)(methyl)amino)-4-metho-xy-5-((4-(1-methyl-1H-indol-3-yl)pyrimidin-2-yl)amino)phenyl)-3-methoxypropanamide. Add- itionally, the In-Silico structure activity relation (QSAR) assessed through statistical based software’s DEREK NexusTM, and MultiCASE, Case UltraTM widely accepted and respected software’s for DP and OSM.

Osimertinib合成路线图解

本文通过Osimertinib原研路线,分析总结了B法和C法两种合成路线,两种路线各有优劣,可通过进一步优化工艺路线适用于工业化生产。

CD47 blockade improves the therapeutic effect of osimertinib in non-small cell lung cancer

The third-generation epidermal growth factor receptor (EGFR) inhibitor osimertinib (OSI) has been approved as the first-line treatment for EGFR-mutant non-small cell lung cancer (NSCLC). This study aims to explore a rational combination strategy for enhancing the OSI efficacy. In this study, OSI induced higher CD47 expression, an important anti-phagocytic immune checkpoint, via the NF-κB pathway in EGFR-mutant NSCLC HCC827 and NCI-H1975 cells. The combination treatment of OSI and the anti-CD47 antibody exhibited dramatically increasing phagocytosis in HCC827 and NCI-H1975 cells, which highly relied on the antibody-dependent cellular phagocytosis effect. Consistently, the enhanced phagocytosis index from combination treatment was reversed in CD47 knockout HCC827 cells. Meanwhile, combining the anti-CD47 antibody significantly augmented the anticancer effect of OSI in HCC827 xenograft mice model. Notably, OSI induced the surface exposure of “eat me” signal calreticulin and reduced the expression of immune-inhibitory receptor PD-L1 in cancer cells, which might contribute to the increased phagocytosis on cancer cells pretreated with OSI. In summary, these findings suggest the multidimensional regulation by OSI and encourage the further exploration of combining anti-CD47 antibody with OSI as a new strategy to enhance the anticancer efficacy in EGFR-mutant NSCLC with CD47 activation induced by OSI.

甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期非小细胞肺癌的临床效果分析

目的探讨甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期非小细胞肺癌(NSCLC)的临床效果。方法选取2018年10月至2023年1月首都医科大学宣武医院收治的105例晚期NSCLC患者为研究对象。依照随机数字表法分为对照组(52例)和观察组(53例)。对照组给予培美曲塞二钠加卡铂化疗,观察组在对照组基础上给予甲磺酸奥希替尼治疗,3周为1个疗程,2组均连续治疗2个疗程。治疗后进行疾病控制率评价,比较2组治疗前后的Karnofsky功能状态(KPS)评分、CD_(3)^(+)、CD_(4)^(+)水平、CD_(4)^(+)/CD_(8)^(+)比值及细胞角蛋白19片段(CYFRA21-1)、癌胚抗原、胸苷激酶1水平及治疗期间不良反应发生率。结果观察组疾病控制率高于对照组[83.0%(44/53)比65.4%(34/52)],差异有统计学意义(P<0.05)。治疗后观察组KPS评分高于对照组[(76±6)分比(64±6)分];观察组CD_(3)^(+)、CD_(4)^(+)水平及CD_(4)^(+)/CD_(8)^(+)比值高于治疗前且高于对照组;2组CYFRA21-1、癌胚抗原、胸苷激酶1水平均低于治疗前且观察组低于对照组,差异均有统计学意义(均P<0.05)。治疗期间,观察组与对照组不良反应发生率差异无统计学意义[13.2%(7/53)比9.6%(5/52)](P>0.05)。结论甲磺酸奥希替尼联合常规培美曲塞二钠加卡铂化疗方法治疗晚期NSCLC的临床效果较好,有助于患者生活质量和免疫功能的提高,且具有较好的安全性。

奥希替尼联合培美曲塞、顺铂治疗EGFR突变阳性晚期非小细胞肺癌的临床效果

目的分析奥希替尼联合培美曲塞、顺铂对表皮生长因子受体(EGFR)突变阳性晚期非小细胞肺癌(NSCLC)的疗效。方法选取2020年2月至2022年2月南阳市中心医院收治的148例EGFR突变阳性晚期NSCLC患者,按随机数表法分为靶向治疗组与化疗组,各74例。化疗组接受培美曲塞、顺铂治疗,靶向治疗组接受奥希替尼联合培美曲塞、顺铂治疗。对比两组疾病控制率、T淋巴细胞亚群(CD4^(+)、CD8^(+))、血管生成指标[细胞质胸苷激酶(TK1)、血管内皮生长因子(VEGF)]、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原50(CA50)、糖类抗原125(CA125)]、卡氏功能状态评分(KPS)、不良反应发生率。结果靶向治疗组疾病控制率[60.81%(45/74)]较化疗组[44.59%(33/74)]高(P<0.05)。治疗后,靶向治疗组CD4^(+)较化疗组高,CD8^(+)较化疗组低(P<0.05)。治疗后,靶向治疗组TK1、VEGF较化疗组低(P<0.05)。治疗后,靶向治疗组血清CEA、CA50、CA125水平较化疗组低(P<0.05)。治疗后,靶向治疗组KPS评分较化疗组高(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论奥希替尼联合培美曲塞、顺铂治疗EGFR突变阳性晚期NSCLC,能改善免疫功能,抑制血管生成,降低肿瘤标志物水平,提高疾病控制率,改善机体功能状况,且安全性良好。

奥希替尼联合培美曲塞/铂类对表皮生长因子受体合并TP53基因突变的非小细胞肺癌疗效及预后分析

目的探究奥希替尼联合培美曲塞/铂类对EGFR合并TP53突变的非小细胞肺癌(NSCLC)疗效及预后分析。方法选取中国人民解放军联勤保障部队第904医院在2016年1月至2022年6月间诊治的80例表皮生长因子受体合并TP53基因突变的NSCLC患者纳入本次研究,随机数字法分为对照组(40例)和研究组(40例)。对照组行奥希替尼治疗,研究组行奥希替尼联合培美曲塞/铂类化疗治疗。对两组临床疗效、血清指标水平、用药安全性以及预后进行对比分析。结果研究组总缓解率(ORR)和疾病控制率(DCR)均优于对照组(P<0.05)。治疗后,两组细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)水平均低于治疗前(P<0.05),研究组低于对照组(P<0.05)。治疗后,两组白细胞介素4(IL-4)、血管内皮生长因子(VEGF)、细胞间黏附分子-1(ICAM-1)水平均低于治疗前(P<0.05),研究组低于对照组(P<0.05)。两组不良反应差异无统计学意义(P>0.05)。研究组随访1年后的生存率明显高于对照组(P<0.05)。治疗后,两组生存质量测定表(EORTC QLQ-C30)评分高于治疗前(P<0.05),研究组高于对照组(P<0.05)。结论奥希替尼联合培美曲塞/铂类化疗方案用于EGFR合并TP53基因突变的NSCLC的临床治疗,可有效发挥抗肿瘤效果,下调炎症水平,提升疗效,改善患者预后,且用药具有较高安全性,不会明显增加不良反应。

奥希替尼联合化疗在伴有EGFR突变晚期非小细胞肺癌一线治疗中的应用

1文献来源Planchard D,Jänne PA,Cheng Y,et al.Osimertinib with or without chemotherapy in EGFR⁃mutated advanced NSCLC[J].N Engl J Med,2023,389(21):1935-1948.2证据水平1b。

奥希替尼序贯和吉非替尼治疗EGFR突变型晚期非小细胞肺癌近期生存获益的临床研究

目的:探讨奥希替尼序贯和吉非替尼治疗对表皮生长因子受体(EGFR)突变型晚期非小细胞肺癌(NSCLC)患者近期生存获益的影响。方法:回顾性收集2017年7月~2022年7月期间某院收治的150例吉非替尼耐药后EGFR突变型晚期NSCLC患者作为研究对象,将使用奥希替尼序贯治疗的患者纳入序贯组(n=78),使用吉非替尼治疗的患者纳入对照组(n=72)。对照组给予吉非替尼片加量治疗,序贯组给予甲磺酸奥希替尼片序贯治疗,两组均治疗3个疗程。比较两组临床疗效、肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原199(CA199)]水平、生存质量[生存质量核心问卷(QLQ-C30)评分]及不良反应发生情况。结果:治疗后,序贯组治疗总有效率及生存获益率均高于对照组(P<0.05);两组血清CEA、CA125、CA199水平均降低(P<0.05),且序贯组低于对照组(P<0.05);两组QLQ-C30功能评分均升高(P<0.05),且序贯组高于对照组(P<0.05);两组QLQ-C30症状评分均降低(P<0.05),且序贯组低于对照组(P<0.05);两组脱发、白细胞减少、胃肠道症状和肝肾功能异常发生率比较均无统计学差异(P>0.05)。结论:使用奥希替尼序贯和吉非替尼治疗EGFR突变型晚期NSCLC患者临床疗效确切,可有效降低血清肿瘤标志物水平,改善患者生存质量。

奥希替尼联合尼妥珠单抗一线治疗表皮生长因子受体突变晚期非小细胞肺癌患者的临床疗效

目的探讨奥希替尼联合尼妥珠单抗一线治疗表皮生长因子受体(EGFR)突变晚期非小细胞肺癌(NSCLC)患者的临床疗效。方法依据治疗方式的不同将160例EGFR突变晚期NSCLC患者分为观察组和对照组,每组80例,对照组患者给予奥希替尼治疗,观察组患者给予奥希替尼联合尼妥珠单抗治疗。比较两组患者的临床疗效、血清肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)]水平、血清生长因子[胰岛素样生长因子-1(IGF-1)、血管内皮生长因子(VEGF)]水平、不良反应发生情况及随访1年生存情况。结果治疗3个月后,观察组患者的治疗总有效率为57.50%,高于对照组患者的38.75%,差异有统计学意义(P﹤0.05)。治疗后,两组患者血清CEA、CYFRA21-1、CA125、VEGF、IGF-1水平均低于本组治疗前,观察组患者CEA、CYFRA21-1、CA125、VEGF、IGF-1水平均低于对照组,差异均有统计学意义(P﹤0.05)。两组患者腹泻、恶心呕吐、皮疹、肝功能损伤及肾功能损伤发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者的1年生存率为96.25%,高于对照组患者的78.75%,差异有统计学意义(P﹤0.05)。结论奥希替尼联合尼妥珠单抗一线治疗EGFR突变晚期NSCLC疗效显著,能够降低患者肿瘤标志物和生长因子水平,改善患者的预后,安全性良好。

奥希替尼联合同步放化疗治疗EGFR T790M突变的晚期非小细胞肺癌患者的临床效果

目的 探讨奥希替尼联合同步放化疗治疗表皮生长因子受体(EGFR)T790M突变的晚期非小细胞肺癌(NSCLC)患者的临床效果。方法 选取2016年3月至2018年9月本院收治的82例EGFR T790M突变的晚期NSCLC患者,采用随机数字表法将其分为对照组(41例)和观察组(41例)。对照组给予同步放化疗治疗,观察组给予奥希替尼联合同步放化疗治疗。比较两组的治疗效果。结果 观察组的疾病控制率、客观缓解率高于对照组,差异具有统计学意义(P<0.05)。观察组的Ⅰ+Ⅱ级皮疹、胃肠道反应、甲沟炎发生率高于对照组,差异具有统计学意义(P<0.05)。随访2年,观察组的无进展生存时间(PFS)为11.32(6.85,12.41)个月,长于对照组的7.29(4.91,9.32)个月(P<0.05);随访1、2年,观察组的生存率为75.61%、39.02%,高于对照组的56.10%、12.20%,差异具有统计学意义(P<0.05)。结论 奥希替尼联合同步放化疗治疗EGFR T790M突变的晚期NSCLC患者可提高近远期治疗效果,延长PFS,提升患者生存率,具有较高的临床应用价值。

贝伐珠单抗联合奥希替尼治疗伴EGFRT790M突变的晚期NSCLC的疗效观察

目的探讨伴表皮生长因子受体-T790M(EGFRT790M)突变的晚期非小细胞肺癌(NSCLC)应用贝伐珠单抗联合奥希替尼治疗的临床疗效。方法选取接受治疗并经病理检查证实伴EGFRT790M突变的晚期NSCLC患者102例进行研究。应用随机数字表法将上述患者分为对照组(n=51)与观察组(n=51)。对照组患者给予奥希替尼治疗,观察组患者给予贝伐珠单抗联合奥希替尼治疗,两组患者均治疗3个月。比较两组患者的近期疗效、远期疗效、血清指标[糖类抗原125(CA125)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)]以及治疗过程中的不良反应。结果观察组患者治疗有效率为56.86%,高于对照组患者的治疗有效率(35.29%)(P<0.05);观察组患者有效控制率为88.24%,与对照组患者的有效控制率(78.43%)比较无统计学差异(P>0.05);观察组患者进展率为23.53%,低于对照组患者的进展率(47.06%)(P<0.05);观察组患者无进展生存期长于对照组患者(P<0.05);观察组患者病死率为9.80%,低于对照组患者病死率(31.37%)(P<0.05);治疗3个月后,观察组患者CA125、CEA、VEGF水平均低于对照组患者(P<0.05);治疗过程中,观察组不良反应率与对照组比较无统计学意义(P>0.05)。结论贝伐珠单抗联合奥希替尼治疗伴EGFRT790M突变的晚期NSCLC患者的临床疗效良好,可提高患者无进展生存期、降低肿瘤标志物表达水平。

参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的疗效分析

[目的]探讨参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的疗效分析。[方法]选取2021年4月—2022年4月本院收治的表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌患者110例,按照随机数表法分2组,对照组(55例)给予奥希替尼,研究组(55例)在对照组基础上加用参莲胶囊。比较两组治疗效果、用药安全性、欧洲癌症研究和治疗组织肿瘤患者生存质量量表(EORTCQLQ-LC43)评分以及癌胚抗原(CEA),细胞角蛋白19片段(CYFRA21-1),糖类抗原125(CA125)。[结果]研究组总有效率高于对照组(P<0.01)。治疗后,两组患者血清CEA,CA125,CYFRA21-1水平明显低于治疗前(P<0.01),研究组血清CEA,CA125和CYFRA21-1水平明显低于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。治疗后研究组和对照组患者角色功能、生理功能、认知功能、社会功能、情感功能、总健康状况评分均较治疗前明显增加(P<0.05),治疗后研究组角色功能、生理功能、认知功能、社会功能、情感功能、总健康状况评分高于对照组(P<0.05)。[结论]参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的治疗效果较好,并具有安全性,还可以有效降低血清CEA,CA125和CYFRA21-1水平,提高患者生活质量,在临床上有着广阔的应用前景。

奥希替尼靶向治疗晚期非小细胞肺癌临床研究

目的探讨奥希替尼靶向治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法选取医院肿瘤科2021年1月至2022年12月收治的晚期NSCLC患者113例,根据治疗方案的不同分为化学药物治疗(简称化疗)组(54例)和靶向治疗(简称靶向)组(59例)。化疗组患者予注射用培美曲塞二钠+注射用顺铂静脉滴注,靶向组患者口服甲磺酸奥希替尼片。结果靶向组疾病控制率为93.22%,显著高于化疗组的74.07%(P<0.05)。两组患者治疗后的血清癌胚抗原、鳞状上皮细胞癌抗原、细胞角蛋白19片段抗原21-1水平均显著降低(P<0.05),且靶向组患者改善幅度显著大于化疗组(P<0.05)。靶向组患者治疗后的T淋巴细胞亚群CD_(4)^(+)水平显著升高,CD_(8)^(+)水平显著降低,CD_(4)^(+)/CD_(8)^(+)显著升高(P<0.05)。靶向组不良反应发生率为11.86%,显著低于化疗组的29.63%(P<0.05)。结论奥希替尼靶向治疗晚期NSCLC,可降低患者的血清肿瘤细胞因子水平,且对免疫功能影响轻微。

osimertinib治疗非小细胞肺癌的研究进展

osimertinib是一种口服的、不可逆的、具有T790M突变基因选择性的表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)。2015年11月osimertinib通过美国食品和药物管理局审批在美国上市,批准用于T790M突变阳性的,对第一、二代EGFR-TKI耐药的晚期非小细胞肺癌患者。同时大量与之疗效和耐药性相关的临床试验正在进行之中。