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| 1 | EGFR-TKI类药物治疗晚期非小细胞肺癌的研究进展显示文摘表皮生长因子受体酪氨酸激酶抑制剂(epithelialgrowthfactorreceptortyrosinekinaseinhibitors,EGFR-TKI)引领EGFR突变的晚期非小细胞肺癌精准治疗十多年,EGFR-TKI对EGFR常见突变的晚期非小细胞肺癌的疗效已得到明确的证实。然而对于EGFR罕见突变,EGFR-TKI的疗效在临床上存在众多争议。本文列举了目前已经进入临床阶段的EGFR-TKI类药物在EGFR突变阳性晚期非小细胞肺癌中的中位无进展及总生存期并进行比较,增加了EGFR罕见突变对EGFR-TKI疗效的相关研究,以期为临床EGFR-TKI的合理使用提供参考。 | 李海霞 王慧娟 | 2019 | 中国现代应用药学2019,36,2: | 17 |
| 2 | 第一代表皮生长因子受体酪氨酸激酶抑制剂与含铂化疗一线治疗表皮生长因子受体罕见突变阳性晚期肺腺癌患者的疗效显示文摘目的探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)和含铂化疗一线治疗表皮生长因子受体(EGFR)罕见突变晚期肺腺癌患者的临床疗效。方法收集2012年1月至2018年2月间,在郑州大学附属肿瘤医院经EGFR基因检测的4 276例晚期(ⅢB~Ⅳ期)肺腺癌患者的临床资料,从中筛选出99例EGFR罕见突变患者的组织样本,分析其临床病理特征,一线治疗效果、一线治疗进展后患者的治疗情况和预后。分析EGFR常见突变和罕见突变患者的预后。结果EGFR-TKIs和含铂化疗一线治疗EGFR罕见突变患者的客观缓解率分别为33.0%和27.1%,疾病控制率分别为76.5%和87.5%,差异均无统计学意义(均P>0.05);中位无进展生存时间分别为7.2和4.9个月,差异有统计学意义(P=0.009);总生存时间(OS)分别为14.3和20.7个月,差异有统计学意义(P=0.034)。多因素分析显示,远处转移和吸烟史为影响EGFR罕见突变肺腺癌患者OS的独立因素(均P<0.05)。结论对于EGFR罕见突变的晚期肺腺癌患者,一线使用第一代EGFR-TKIs与含铂化疗比较,可改善患者的近期疗效,但一线含铂化疗的患者生存时间更长。 | 李海霞 王子奇 张国伟 张米娜 郑宣轩 杨金坡 马智勇 王慧娟 | 2019 | 中华肿瘤杂志2019,41,10: | 14 |
| 3 | 含铂化疗及其联合治疗在晚期非小细胞肺癌治疗中的研究进展显示文摘含铂化疗、表皮因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)、抗血管生成治疗、免疫治疗等单独或联合治疗均为晚期非小细胞肺癌的治疗手段。选择单药或联合用药以及联合用药的给药顺序及其效果均为晚期非小细胞肺癌临床治疗的关注热点。近年来,多位学者研究了铂类单药化疗及联合用药的疗效,研究结果不一而足,在一定程度上给临床医师选择用药方案带来了新的挑战。本文就以上相关国内外研究结果进行综述,以供临床用药、研究作参考。 | 钟锐 邬麟 王伟 朱跃红 邱艳芳 | 2019 | 肿瘤药学2019,9,6: | 12 |
| 4 | 非小细胞肺癌EGFR基因突变检测的临床应用进展显示文摘非小细胞肺癌(NSCLC)表皮生长因子受体(EGFR)基因突变与肿瘤细胞增殖、血管生长、肿瘤浸润转移和细胞凋亡抑制相关,在NSCLC中突变率为46%。国内外指南均推荐对NSCLCL患者检测EGFR基因,EGFR基因突变阳性的患者应接受酪氨酸激酶抑制剂(TKI)药物的治疗,可较传统化疗方案延长EGFR基因突变阳性NSCLC患者的无进展生存(PFS)时间和总生存(OS)时间。EGFR基因检测以组织作为金标准,但鉴于组织固有异质性及有创性,多种液体活检标本也可辅助用于EGFR基因状态的检测。该文将对NSCLC患者EGFR基因突变检测在临床中的应用研究进展及检测过程应注意的问题作一简要综述。 | 官绍年 陈迎珠 卓明磊 贾淑芹 王国洪 徐国宾 | 2020 | 临床检验杂志2020,38,2: | 12 |
| 5 | PD-L1 expression and its effect on clinical outcomes of EGFRmutant NSCLC patients treated with EGFR-TKIs显示文摘Objective:Epidermal growth factor receptor(EGFR)activation was reported to upregulate programmed death-ligand 1(PD-L1)expression in lung cancer cells and subsequently contribute to immune escape,indicating its critical role in EGFR-driven lung tumors.This study characterized PD-L1 expression in patients with surgically resected EGFR-mutant non-small cell lung cancer(NSCLC).The effect of PD-L1 expression on clinical outcomes was also investigated in advanced EGFR-mutant NSCLC treated with EGFR-tyrosine kinase inhibitors(TKIs).Methods:In total,73 patients with surgically resected NSCLC and EGFR mutations were identified.PD-L1 expression and CD8+tumor-infiltrating lymphocyte(TIL)density were assessed by immunohistochemistry.A literature review of publications that assessed the predictive and prognostic value of PD-L1 expression in advanced EGFR-mutant NSCLC patients treated with EGFR-TKIs was performed.Results:Nineteen(26.0%)patients were positive for PD-L1 expression,which was significantly associated with concomitant KRAS mutation(P=0.020)and marginally associated with higher CD8+TILs density(P=0.056).Positive PD-L1 expression was associated with markedly inferior overall survival(OS)in multivariate analysis(P=0.032).The combination of PD-L1 and CD8+TILs expression could be used to stratify the population into three groups with distinct prognoses.A meta-analysis of six publications showed that positive PD-L1 expression was not associated with OS[hazard ratio(HR)=0.90;95%confidence interval(CI),0.42–1.38]or progression-free survival(HR=1.03;95 CI,0.73–1.33)in advanced EGFR-mutant NSCLC patients receiving EGFR-TKIs.Conclusions:PD-L1 expression tended to correlate with CD8+TIL expression,concomitant KRAS mutation,and poor survival in surgically resected EGFR-mutant NSCLC.PD-L1 expression was neither the predictive nor the prognostic factor in advanced EGFR-mutant NSCLC patients treated with EGFR-TKIs. | Yuchen Bai Xiaoxia Chen Likun Hou Jun Qian Tao Jiang Caicun Zhou Maciej Ciebiada | 2018 | Cancer Biology & Medicine2018,15,4: | 5 |
| 6 | Investigation of therapeutic modalities of G719X, an uncommon mutation in the EGFR gene in non-small cell lung cancer显示文摘Objective G719 X is the most frequently seen uncommon mutation of the epidermal growth factor receptor(EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719 A/G719 C/G719 S. This study explored the clinicopathological characteristics of the G719 X mutation and investigated the efficacy of EGFR-tyrosine kinase inhibitor(TKI) treatment and chemotherapy in patients with the G719 X mutation; the survival rate after these different treatment modalities were then analyzed in order to provide evidence for clinical treatment.Methods Clinical data of 41 patients with the G719 X mutation admitted in the Beijing Chest Hospital, Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations were detected by amplification refractory mutation system-polymerase chain reaction(ARMS-PCR). The clinicopathological characteristics of the G719 X mutation were analyzed, and the relationship among the G719 X mutation, the efficacy of different treatment modalities, and the progression-free survival(PFS) was analyzed. Results Of the 41 cases, 24(58.5%) were G719 X single mutations and 17(41.5%) were compound mutations, including G719 X/S768 I, G719 X/L861 Q, G719 X/19 del, and G719 X/c-Met compound mutation. The objective response rate(ORR) of first-line EGFR-TKI therapy was 50%(6/12), the disease control rate(DCR) was 83.3%(10/12), and the median PFS(mPFS) was 9 months. After resistance to EGFR-TKI in the previous treatment, the ORR(71.4%, 5/7) and DCR(100%, 7/7) were still high following EGFR-TKIs, by an mPFS of 8 months. The ORR of chemotherapy was 33.3%(2/6), the DCR was 100%(6/6), and the mPFS was 6 months. Conclusion G719 X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs. It can be treated with the second-or third-generation EGFR-TKIs after resistance to the first-generation EGFR-TKIs. G719 X mutation also showed favorable effect to chemotherapy. | Hua Zheng Yuan Gao Zan Liu Zhe Qian Tongmei Zhang Jie Li Hongmei Zhang Qunhui Wang Fanbin Hu Baolan Li | 2019 | Oncology and Translational Medicine2019,5,2: | 1 |