阿帕替尼联合替吉奥治疗晚期非小细胞肺癌的疗效分析
|
摘要
目的观察甲磺酸阿帕替尼联合替吉奥治疗晚期非小细胞肺癌的疗效及不良反应。方法 2016年10月-2017年6月我院共收治40例经病理学确诊的非小细胞肺癌患者进行,所有患者均为二线或二线以上治疗失败,既往接受过含铂类化疗方案(包含分子靶向治疗)。40例患者按1∶1分为联合用药组(阿帕替尼联合替吉奥)20例,阿帕替尼单药组20例,观察两组患者的临床疗效及不良反应。结果全部患者均可评价疗效。联合用药组及阿帕替尼单药组中位无进展期(PFS)分别为4.3和2.9个月,中位生存期(OS)分别为5.0和4.0个月,差异均有显著性(P<0.05)。联合用药组总缓解率(ORR)和疾病控制率(DCR)分别为25%和75%,阿帕替尼单药组分别为13%和67%。联合用药组及阿帕替尼单药组主要不良反应均为高血压、手足综合征、蛋白尿、骨髓抑制、纳差及腹泻,联合用药组未出现非预期不良反应。结论阿帕替尼联合替吉奥治疗晚期非小细胞肺癌有较好的疾病控制率及生存获益,不良反应可控制,值得临床进一步研究和应用。
Objective To observe the clinical efficacy and adverse reactions of apatinib combined with S-1 in the treatment of advanced non-small cell lung cancer.Methods Forty cases of non-small cell lung cancer patients pathologically confirmed in our hospital between October 2016 and June 2017 were collected. All these patients had suffered from second-line treatment failure or received platinum chemotherapy( including molecular targeted therapy). These patients were equally divided into the combined treatment group( apatinib combined with s-1) and apatinib alone group. The therapeutic effect and adverse reactions were observed in both groups.Results All the patients were assessed in terms of therapeutic effect. The median progression free survival( PFS) of the combined treatment group and apatinib alone group was 4.3 months and 2.9 months( P<0.05) respectively. The overall survival( OS) was 5 months and 4 months respectively,and the difference was significant. The overall response rate( ORR) and disease control rate( DCR) were 25% and 75% respectively in the combined treatment group,compared with 13% and 67% in the apatinib alone group. The main adverse reactions in both groups were hypertension,hand-foot syndrome,proteinuria,myelosuppression,anorexia and diarrhea. No unexpected adverse reactions occurred in the combined treatment.Conclusion Apatinib combined with S-1 in the treatment of advanced non-small cell lung cancer can still achieve better disease control and survival benefit. Adverse reactions can be controlled,and it is worthy of further clinical research and application.
Objective To observe the clinical efficacy and adverse reactions of apatinib combined with S-1 in the treatment of advanced non-small cell lung cancer.Methods Forty cases of non-small cell lung cancer patients pathologically confirmed in our hospital between October 2016 and June 2017 were collected. All these patients had suffered from second-line treatment failure or received platinum chemotherapy( including molecular targeted therapy). These patients were equally divided into the combined treatment group( apatinib combined with s-1) and apatinib alone group. The therapeutic effect and adverse reactions were observed in both groups.Results All the patients were assessed in terms of therapeutic effect. The median progression free survival( PFS) of the combined treatment group and apatinib alone group was 4.3 months and 2.9 months( P<0.05) respectively. The overall survival( OS) was 5 months and 4 months respectively,and the difference was significant. The overall response rate( ORR) and disease control rate( DCR) were 25% and 75% respectively in the combined treatment group,compared with 13% and 67% in the apatinib alone group. The main adverse reactions in both groups were hypertension,hand-foot syndrome,proteinuria,myelosuppression,anorexia and diarrhea. No unexpected adverse reactions occurred in the combined treatment.Conclusion Apatinib combined with S-1 in the treatment of advanced non-small cell lung cancer can still achieve better disease control and survival benefit. Adverse reactions can be controlled,and it is worthy of further clinical research and application.
引文
[1]SIEGEL R,NAISHADHAM D,JEMAL A.Cancer statistics for Hispanics/Latinos,2015[J].CA Cancer J Clin,2012,62(5):283.
[2]ZHANG,H.Apatinib for molecular targeted therapy in tumor[J].Drug Des Devel Ther,2015,9:6075.
[3]薛慧,王文武,欧阳学农.S-1治疗晚期非小细胞肺癌临床新进展[J].实用临床医药杂志,2011,15(3):125.
[4]ONO A,NAITO T,MURAKAMI H,et al.Evaluation of S-1 as third-or further-line chemotherapy in advanced non-small-cell lung cancer[J].Int J Clin Oncol,2010,15(3):331.
[5]NISHIYAMA O,TANIGUCHI H,KONDOH Y,et al.Phase II study of S-1 monotherapy as a first-line treatment for elderly patients with advanced nonsmall-cell lung cancer:the Central Japan Lung Study Group trial0404[J].Anticancer Drugs,2011,22(8):811.
[6]秦叔逵,李进.阿帕替尼治疗胃癌的临床应用专家共识[J].临床肿瘤学杂志,2015(9):841.
[7]LI J,QIN S,XU J,et al.Apatinib for chemotherapy-refractory advanced metastatic gastric cancer:results from a randomized,placebo-controlled,parallel-arm,phase II trial[J].J Clin Oncol,2013,31(26):3219.
[8]HU X,CAO J,HU W,et al.Multicenter phase II study of apatinib in non-triple-negative metastatic breast cancer[J].BMC Cancer,2014,14:820.
[9]张力,李凯,史美祺.甲磺酸甲磺酸阿帕替尼片治疗晚期非鳞非小细胞肺癌随机、双盲、安慰剂对照、多中心Ⅱ期临床研究[C].第十五届全国临床肿瘤学大会暨2012年CSCO学术年会.2012.
[10]DING L,LI Q J,YOU K Y,et al.The Use of Apatinib in Treating Nonsmall-Cell Lung Cancer:Case Report and Review of Literature[J].Medicine(Baltimore),2016,95(20):e3598.
[11]陈素华,马天江,崔巍,等.单药替吉奥在Ⅳ期非小细胞肺癌治疗中的疗效分析[J].中国医药指南,2014(18):172.
[12]KUBOTA K,SAKAI H,KATAKAMI N,et al.A randomized phase III trial of oral S-1 plus cisplatin versus docetaxel plus cisplatin in Japanese patients with advanced non-small-cell lung cancer:TCOG0701 CATS trial[J].Ann Oncol,2015,26(7):1401.
[2]ZHANG,H.Apatinib for molecular targeted therapy in tumor[J].Drug Des Devel Ther,2015,9:6075.
[3]薛慧,王文武,欧阳学农.S-1治疗晚期非小细胞肺癌临床新进展[J].实用临床医药杂志,2011,15(3):125.
[4]ONO A,NAITO T,MURAKAMI H,et al.Evaluation of S-1 as third-or further-line chemotherapy in advanced non-small-cell lung cancer[J].Int J Clin Oncol,2010,15(3):331.
[5]NISHIYAMA O,TANIGUCHI H,KONDOH Y,et al.Phase II study of S-1 monotherapy as a first-line treatment for elderly patients with advanced nonsmall-cell lung cancer:the Central Japan Lung Study Group trial0404[J].Anticancer Drugs,2011,22(8):811.
[6]秦叔逵,李进.阿帕替尼治疗胃癌的临床应用专家共识[J].临床肿瘤学杂志,2015(9):841.
[7]LI J,QIN S,XU J,et al.Apatinib for chemotherapy-refractory advanced metastatic gastric cancer:results from a randomized,placebo-controlled,parallel-arm,phase II trial[J].J Clin Oncol,2013,31(26):3219.
[8]HU X,CAO J,HU W,et al.Multicenter phase II study of apatinib in non-triple-negative metastatic breast cancer[J].BMC Cancer,2014,14:820.
[9]张力,李凯,史美祺.甲磺酸甲磺酸阿帕替尼片治疗晚期非鳞非小细胞肺癌随机、双盲、安慰剂对照、多中心Ⅱ期临床研究[C].第十五届全国临床肿瘤学大会暨2012年CSCO学术年会.2012.
[10]DING L,LI Q J,YOU K Y,et al.The Use of Apatinib in Treating Nonsmall-Cell Lung Cancer:Case Report and Review of Literature[J].Medicine(Baltimore),2016,95(20):e3598.
[11]陈素华,马天江,崔巍,等.单药替吉奥在Ⅳ期非小细胞肺癌治疗中的疗效分析[J].中国医药指南,2014(18):172.
[12]KUBOTA K,SAKAI H,KATAKAMI N,et al.A randomized phase III trial of oral S-1 plus cisplatin versus docetaxel plus cisplatin in Japanese patients with advanced non-small-cell lung cancer:TCOG0701 CATS trial[J].Ann Oncol,2015,26(7):1401.