克唑替尼靶向治疗非小细胞肺癌疗效及EML4-ALK的表达情况分析
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摘要
目的探讨克唑替尼靶向治疗非小细胞肺癌患者对EML4-ALK的表达的影响。方法选取2010年2月-2016年3月在我院接受治疗的EML4-ALK阳性非小细胞肺癌患者的临床资料。根据其治疗方式分为传统化疗组和克唑替尼靶向治疗组,克唑替尼靶向治疗组在传统化疗的基础上给予克唑替尼靶向治疗。观察治疗6个月后两组患者EML4-ALK阳性表达率和肿瘤标志物水平的变化,比较两组患者1年生存率的差异,分析EML4-ALK阳性表达率与肿瘤标志物水平和生存率的相关性。结果两组患者治疗前EML4-ALK阳性表达率均为100%,治疗后,靶向治疗组EML4-ALK阳性表达率低于传统化疗组(P<0.05);两组患者治疗前的CEA、NSE和CYFRA21-1等肿瘤标志物水平无明显差别,治疗后,靶向治疗组低于传统治疗组(P<0.05);靶向治疗组1年生存率明显高于传统化疗组;患者的EML4-ALK阳性表达率与CEA、NSE、CYFRA21-1明显正相关,与生存率明显负相关。结论克唑替尼靶向治疗可明显降低非小细胞肺癌患者的EML4-ALK阳性表达率,提高其生存率。
Objective To investigate the effect of crizotinib as targeted therapy on EML4-ALK expression in patients with non small cell lung cancer. Methods The clinical data of patients with non small cell lung cancer treated in our hospital from February 2010 to March 2016 were retrospectively analyzed. According to the treatment methods,they were divided into two groups: the traditional chemotherapy group and the targeted group. The targeted therapy group was given the targeted therapy of traditional Chinese medicine on the basis of traditional chemotherapy. After 6 months of treatment,the EML4-ALK positive expression and tumor marks were observed in the two groups. The difference of 1-year survival rate of the two groups were compared,and the correlation between the positive expression rate of EML4-ALK and the level of tumor markers and the survival rate were analyzed. Results The positive expression of EML4-ALK in the two groups before treatment was 100%,and the positive expression of EML4-ALK in the targeted therapy group was lower than that in the conventional chemotherapy group( P < 0. 05). The level of CEA,NSE and CYFRA21-1 and other tumor markers of the two groups before treatment had no significantly difference. After treatment,the targeted therapy group was lower than the traditional treatment group( P < 0. 05). The 1-year survival rate of the targeted therapy group was significantly higher than that of the traditional chemotherapy group. The expression of EML4-ALK positive rate were significantly positively correlated with the level of CEA,NSE and CYFRA21-1,and was negatively correlated with the survival rate. Conclusion The targeted therapy can significantly decrease the positive expression rate of EML4-ALK in patients with non small cell lung cancer,and improve the survival rate of patients with non small cell lung cancer.
Objective To investigate the effect of crizotinib as targeted therapy on EML4-ALK expression in patients with non small cell lung cancer. Methods The clinical data of patients with non small cell lung cancer treated in our hospital from February 2010 to March 2016 were retrospectively analyzed. According to the treatment methods,they were divided into two groups: the traditional chemotherapy group and the targeted group. The targeted therapy group was given the targeted therapy of traditional Chinese medicine on the basis of traditional chemotherapy. After 6 months of treatment,the EML4-ALK positive expression and tumor marks were observed in the two groups. The difference of 1-year survival rate of the two groups were compared,and the correlation between the positive expression rate of EML4-ALK and the level of tumor markers and the survival rate were analyzed. Results The positive expression of EML4-ALK in the two groups before treatment was 100%,and the positive expression of EML4-ALK in the targeted therapy group was lower than that in the conventional chemotherapy group( P < 0. 05). The level of CEA,NSE and CYFRA21-1 and other tumor markers of the two groups before treatment had no significantly difference. After treatment,the targeted therapy group was lower than the traditional treatment group( P < 0. 05). The 1-year survival rate of the targeted therapy group was significantly higher than that of the traditional chemotherapy group. The expression of EML4-ALK positive rate were significantly positively correlated with the level of CEA,NSE and CYFRA21-1,and was negatively correlated with the survival rate. Conclusion The targeted therapy can significantly decrease the positive expression rate of EML4-ALK in patients with non small cell lung cancer,and improve the survival rate of patients with non small cell lung cancer.
引文
[1]沈晓宇,马锐.岩舒注射液雾化吸入联合奥沙利铂、吉西他滨化疗治疗非小细胞肺癌近期疗效研究[J].现代仪器与医疗,2016,22(1):110-112.
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[7]陈刚,王国栋,王乃辉.mir-615-5p通过靶向调节癌基因TRAF4抑制非小细胞肺癌细胞的增殖[J].中国生物化学与分子生物学报,2016,32(2):184-190.
[8]Matsuo N,Sekine A,Kato T,et al.Promising Effect of Crizotinib on Anaplastic Lymphoma Kinase(ALK)-Positive Non-Small Cell Lung Cancer in an Elderly Patient with a Poor Performance Status:A Case Report and Literature Review[J].Intern Med,2016,55(5):507-509.
[9]Solomon BJ,Cappuzzo F,Felip E,et al.Intracranial Efficacy of Crizotinib Versus Chemotherapy in Patients With Advanced ALKPositive Non-Small-Cell Lung Cancer:Results From PROFILE1014[J].J Clin Oncol,2016,34(24):2858-2865.
[10]van der Wekken AJ,Saber A,Hiltermann TJ,et al.Resistance mechanisms after tyrosine kinase inhibitors afatinib and crizotinib in non-small cell lung cancer,a review of the literature[J].Crit Rev Oncol Hematol,2016,100:107-116.
[11]赵静,张坤,张力予,等.克唑替尼治疗ALK阳性晚期非小细胞肺癌患者的疗效观察[J].中国肺癌杂志,2015,18(10):616-620.
[12]王杰,衣素琴,王欢,等.非小细胞肺癌中c-Met、EGFR、K-Ras和EML4-ALK基因的检测分析[J].临床肿瘤学杂志,2015,20(10):902-908.
[13]张丽萍,孙宏斌,李文宇,等.老年非小细胞肺癌患者的临床分布与治疗方法研究[J].中国老年学杂志,2015,35(16):4573-4574.
[14]Dudnik E,Siegal T,Zach L,et al.Durable brain response with pulse-dose crizotinib and ceritinib in ALK-positive non-small cell lung cancer compared with brain radiotherapy[J].J Clin Neurosci,2016,26:46-49.
[15]张宁宁,韩晓红,石远凯.间变淋巴瘤激酶阳性非小细胞肺癌靶向治疗现状[J].中华结核和呼吸杂志,2015,38(10):773-777.
[2]王文娴,宋正波,余新民,等.克唑替尼治疗28例间变性淋巴瘤激酶阳性晚期非小细胞肺癌疗效分析[J].中华肿瘤杂志,2015,37(10):784-787.
[3]周惠君,董萍,蔡华伟,等.含神经纤毛蛋白-1靶向序列的细胞穿透肽的合成及其与非小细胞肺癌的特异性结合研究[J].四川大学学报(医学版),2016,47(1):19-22,38.
[4]蒋涛,周彩存.ALK阳性非小细胞肺癌患者克唑替尼耐药的机制和治疗措施[J].中国肺癌杂志,2015,18(2):69-74.
[5]石远凯,郏博,孙燕.克唑替尼——晚期非小细胞肺癌治疗的新选择[J].中华医学杂志,2013,93(16):1272-1275.
[6]刘雨桃,王子平,胡兴胜,等.克唑替尼对ALK融合基因阳性脑转移肺癌患者的疗效分析[J].中国新药杂志,2015,24(15):1760-1764,1770.
[7]陈刚,王国栋,王乃辉.mir-615-5p通过靶向调节癌基因TRAF4抑制非小细胞肺癌细胞的增殖[J].中国生物化学与分子生物学报,2016,32(2):184-190.
[8]Matsuo N,Sekine A,Kato T,et al.Promising Effect of Crizotinib on Anaplastic Lymphoma Kinase(ALK)-Positive Non-Small Cell Lung Cancer in an Elderly Patient with a Poor Performance Status:A Case Report and Literature Review[J].Intern Med,2016,55(5):507-509.
[9]Solomon BJ,Cappuzzo F,Felip E,et al.Intracranial Efficacy of Crizotinib Versus Chemotherapy in Patients With Advanced ALKPositive Non-Small-Cell Lung Cancer:Results From PROFILE1014[J].J Clin Oncol,2016,34(24):2858-2865.
[10]van der Wekken AJ,Saber A,Hiltermann TJ,et al.Resistance mechanisms after tyrosine kinase inhibitors afatinib and crizotinib in non-small cell lung cancer,a review of the literature[J].Crit Rev Oncol Hematol,2016,100:107-116.
[11]赵静,张坤,张力予,等.克唑替尼治疗ALK阳性晚期非小细胞肺癌患者的疗效观察[J].中国肺癌杂志,2015,18(10):616-620.
[12]王杰,衣素琴,王欢,等.非小细胞肺癌中c-Met、EGFR、K-Ras和EML4-ALK基因的检测分析[J].临床肿瘤学杂志,2015,20(10):902-908.
[13]张丽萍,孙宏斌,李文宇,等.老年非小细胞肺癌患者的临床分布与治疗方法研究[J].中国老年学杂志,2015,35(16):4573-4574.
[14]Dudnik E,Siegal T,Zach L,et al.Durable brain response with pulse-dose crizotinib and ceritinib in ALK-positive non-small cell lung cancer compared with brain radiotherapy[J].J Clin Neurosci,2016,26:46-49.
[15]张宁宁,韩晓红,石远凯.间变淋巴瘤激酶阳性非小细胞肺癌靶向治疗现状[J].中华结核和呼吸杂志,2015,38(10):773-777.