阿帕替尼联合三线化疗治疗晚期非小细胞肺癌的临床疗效
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摘要
目的:探讨阿帕替尼联合三线化疗治疗晚期非小细胞肺癌的临床疗效。方法:回顾性研究我院2015年06月至2017年06月给予阿帕替尼联合化疗治疗的晚期非小细胞肺癌患者22例,服用阿帕替尼联合化疗两周期后评估疗效和不良反应。结果:阿帕替尼联合化疗治疗晚期非小细胞肺癌,部分缓解率(PR)9.1%,疾病稳定率(SD)36.4%;常见的阿帕替尼相关不良反应发生率为乏力36.4%,高血压27.3%,口腔黏膜炎9.1%,且基本为1-2级不良反应。结论:阿帕替尼联合三线化疗治疗晚期非小细胞肺癌有一定的临床疗效,能够延长患者的生存时间,且耐受性良好。
Objective:To investigate the clinical effect of apatinib combined with third-line chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods:A retrospective study of 22 patients with advanced non-small cell lung cancer(NSCLC) treated with apatinib combined chemotherapy from June 2015 to June 2017 was conducted to evaluate the efficacy and adverse reactions after two cycles of apatinib combined chemotherapy.Results:In the treatment of advanced non-small cell lung cancer(NSCLC),the partial remission rate(PR) was 9. 1%,and the disease stability rate was 36. 4%. Apatinib related adverse reactions included: feeble(36. 4%),hypertension(27. 3%),oral mucositis(9. 1%),and basically 1-2 grade adverse reactions. Conclusion: Apatinib combined with third-line chemotherapy is effective in the treatment of advanced non-small cell lung cancer. It can prolong the survival time of the patients and has good tolerance.
Objective:To investigate the clinical effect of apatinib combined with third-line chemotherapy in the treatment of advanced non-small cell lung cancer(NSCLC).Methods:A retrospective study of 22 patients with advanced non-small cell lung cancer(NSCLC) treated with apatinib combined chemotherapy from June 2015 to June 2017 was conducted to evaluate the efficacy and adverse reactions after two cycles of apatinib combined chemotherapy.Results:In the treatment of advanced non-small cell lung cancer(NSCLC),the partial remission rate(PR) was 9. 1%,and the disease stability rate was 36. 4%. Apatinib related adverse reactions included: feeble(36. 4%),hypertension(27. 3%),oral mucositis(9. 1%),and basically 1-2 grade adverse reactions. Conclusion: Apatinib combined with third-line chemotherapy is effective in the treatment of advanced non-small cell lung cancer. It can prolong the survival time of the patients and has good tolerance.
引文
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[2] Rui Pan,Meng Zhu,Canqing Yu,et al.Cancer incidence and mortality:A cohort study in China,2008-2013[J].Int J Cancer,2017,141:1315-1323.
[3] Reck M,Popat S,Reinmuth N,et al.Metastatic non-small-cell lung cancer (NSCLC):ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up[J].Ann Oncol,2014,25(Suppl 3):27-39.
[4] Majem M,Pallare's C.An update on molecularly targeted therapies in second and third-line treatment in non-small cell lung cancer:Focus on EGFR inhibitors and anti-angiogenic agents[J].Clin Transl Oncol,2013,15(5):343-357.
[5] Feng Jiuhuan,Qin Shukui,Wang Lin.Clinical and experimental progression of mesylate apatinib[J].Chinese Clinical Oncology,2017,22(4):345-356.[冯久桓,秦叔逵,王琳.甲磺酸阿帕替尼的研究现状与进展[J].临床肿瘤学杂志,2017,22(4):345-356.]
[6] Geng R,Li J.Apatinib for the treatment of gastric cancer[J].Expert Opin Pharmacother,2015,16(1):117-122.
[7] Kris MG,Johnson BE,Berry LD,et al.Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs[J].JAMA,2014,311(19):1998-2006.
[8] Shu Tian,Haitian Quan,Chengying Xie,et al.YN968D1 is a novel and selective inhibitor of vascular endothelial growth factor receptor-2 tyrosine kinase with potent activity in vitro and in vivo[J].Cancer Sci,2011,102(7):1374-1380.
[9] Longo R,Gasparini G.Challenges for patient selection with VEGF inhibitors[J].Cancer Chemother Pharmacol,2007,60:151-170.
[10] Qiu-Xia Peng,Yun-Wei Han,Yan-Ling Zhang,et al.Apatinib inhibits VEGFR-2 and angiogenesis in an in vivo murine model of nasopharyngeal carcinoma[J].Oncotarget,2017,8(32):52813-52822.
[11] Han Tingting,Shi Mingwei,Wang Fan,et al.Clinic observation of apatinib in treatment of advancedgastric carcinoma[J].Modern Oncology,2018,26(04):557-559.[韩婷婷,石明伟,王凡,等.阿帕替尼治疗晚期胃癌的临床疗效观察[J].现代肿瘤医学,2018,26(04):557-559.]
[12] Garon EB,Ciuleanu TE,Arrieta O,et al.Ramucirumab plus docetaxel versus placebo plus docetaxel for second-line treatment of stage IV non-small-cell lung cancer after disease progression on platinum-based therapy (REVEL):A multicentre,double-blind,randomised phase 3 trial[J].Lancet,2014,384(9944):665-673.
[13] M Reck,R Kaiser,A Mellemgaard,et al.Docetaxel plus nintedanib versus docetaxel plus placebo in patients with previously treated non-small-cell lung cancer (LUME-Lung 1):A phase 3,double-blind,randomised controlled trial[J].The Lancet Oncology,2014,15(2):143-155.
[14] Minhao Fan,Jian Zhang,Zhonghua Wang,et al.Phosphorylated VEGFR2 and hypertension:Potential biomarkers to indicate VEGF-dependency of advanced breast cancer in anti-angiogenic therapy[J].Breast Cancer Res Treat,2014,143(1):141-151.
[15] Krishna R,Mayer LD.Multidrug resistance (MDR) in cancer:Mechanisms,reversal using modulators of MDR and the role of MDR modulators in influencing the pharmacokinetics of anticancer drugs[J].European Journal of Pharmaceutical Science,2000,11(4):265-283.
[16] Safiulla Basha Syed,Hemant Arya,I-Hsuan Fu,et al.Targeting P-glycoprotein:Investigation of piperine analogs for overcoming drug resistance in cancer[J].Scientific Reports,2017,7(1):7972.
[17] Wei Jin,Xiaodong Liao,Yaping Lv,et al.MUC1 induces acquired chemoresistance by upregulating ABCB1 in EGFR-dependent manner[J].Cell Death and Disease,2017,8(8):e2980.
[18] Yan-jun Mi,Yong-ju Liang,Hong-bing Huang,et al.Apatinib (YN968D1) reverses multidrug resistance by inhibiting the efflux function of multiple ATP-binding cassette transporters[J].Cancer Res,2010,70(20):7981-7991.
[19] Xiu-zhen Tong,Fang Wang,Shu Liang,et al.Apatinib (YN968D1) enhances the efficacy of conventional chemotherapeutical drugs in side population cells and ABCB1-overexpressing leukemia cells[J].Biochemical Pharmacology,2012,83(5):586-597.