表皮生长因子受体突变在晚期非小细胞肺癌靶向治疗中临床价值研究.docVIP

表皮生长因子受体突变在晚期非小细胞肺癌靶向治疗中临床价值研究 　　[摘要] 目的 探讨以表皮生长因子受体（EGFR） 酪氨酸激酶抑制剂getfinibi 为代表的靶向治疗晚期非小细胞肺癌（NSCLC）的可行性。 方法 选取2011年3月―2013年10月32 例经铂类治疗方案失败的晚期 NSCLC 患者应用 getfinibi 250 mg/d 治疗，采用 RECIST标准评价疗效，并对接受 getfinibi 治疗的患者的肿瘤组织进行 EGFR 酪氨酸激酶域基因突变检测。结果 32例标本中共检测出 12 例基因突变。4 例为 19 号染色体缺失突变。8 例为 21 号染色体错义突变，均为 L858R 变异（TG）。经 getfinibi 治疗后 EGFR 基因突变组的客观有效率达 58.33%，疾病控制率达 100.0%，均高于无 EGFR 基因突变组（分别为 10.00%、20.00%）（P0.05）。结论 getfinibi 靶向治疗晚期 NSCLC 疗效明显，getfinibi 治疗效果明显的患者中EGFR 基因突变的发生率高，因此，EGFR 酪氨酸激酶域突变检测可作为患者应用 getfinibi 疗效的一个预测指标。 　　[关键词] 表皮生长因子受体突变；晚期非小细胞肺癌；靶向治疗 　　[中图分类号] R734.2 [文献标识码] A [文章编号] 1674-0742（2014）08（b）-0050-03 　　[Abstract] Objective To discuss the feasibility of targeted therapy represented by epidermal growth factor receptor （EGFR） tyrosine kinase inhibitor getfinibi for advanced non-small cell lung cancer（NSCLC）. Methods 32 cases with advanced NSCLC failed the previous platinum based chemotherapy from March 2011 to October 2013 were selected and treated by getfinibi 250 mg/d. RECIST criteria were used to evaluate the curative effect. And the EGFR tyrosine kinase domain gene mutation in the tumor tissue of the patients with getfinibi treatment was detected. Results Of the 32 cases of specimens， there were 12 cases were detected with gene mutations， including 4 cases with chromosome 19 deletion mutation， 8 cases with missense mutation of chromosome 21， all were L858R mutations （TG）. After treatment with getfinibi， the objective response rate of the EGFR gene mutation group reached 58.33%， the disease control rate reached 100.0%， higher than 10.00%， 20.00% of the non-EGFR gene mutation group， respectively（P0.05）. Conclusion The curative effect of getfinibi targeted therapy on advanced NSCLC is significant. And patients treated by getfinibi with a good effect have high incidence of EGFR gene mutation. Therefore， the EGFR tyrosine kinase domain gene mutation detection can be used as a predictive index for evaluating the curative effect of getfinibi. 　　[Key words]