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中国癌症防治杂志

中国癌症防治杂志 ›› 2022, Vol. 14 ›› Issue (6): 642-646.doi: 10.3969/j.issn.1674-5671.2022.06.08

• 临床研究 • 上一篇    下一篇

埃克替尼与吉非替尼治疗EGFR突变型晚期肺腺癌的临床疗效比较

  

  1. 广西医科大学附属肿瘤医院综合内科；广西医科大学第一附属医院内分泌科
  • 出版日期:2022-12-25 发布日期:2022-12-30
  • 通讯作者: 巫丽丽 E?mail：wuliligxmu@126.com
  • 基金资助:
    广西壮族自治区药品监督管理局科研项目［桂食药科 2018?5（直属）］

Comparison of clinical efficacy of icotinib and gefitinib in the treatment of EGFR⁃mutated advanced lung adenocarcinoma

  • Online:2022-12-25 Published:2022-12-30

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摘要： 目的 比较埃克替尼和吉非替尼治疗表皮生长因子受体（epidermal growth factor receptor，EGFR）突变型晚期肺腺癌患者的临床疗效、不良反应及用药后机体免疫功能状态。方法 选取2012年1月至2019年12月于广西医科大学附属肿瘤医院经病理活检证实为肺腺癌的176例EGFR突变阳性患者作为研究对象，按靶向治疗方案分为埃克替尼组和吉非替尼组，并依据RECIST 1.1标准对患者进行疗效评估；比较两组患者不良反应发生情况、细胞免疫和体液免疫指标的差异。结果 埃克替尼组和吉非替尼组客观缓解率（60.0% vs 63.2%），疾病控制率（94.0% vs 92.1%），中位无进展生存期（9.5个月 vs 8.9个月），中位总生存期（21.7个月 vs 18.5个月），药物总体不良反应发生率（31.0% vs 34.2%）比较，差异均无统计学意义（均P>0.05）；两组细胞免疫指标（CD3+T细胞、CD4+T细胞、CD8+T细胞、CD4+/CD8+、自然杀伤细胞）和体液免疫指标IgM比较，差异均无统计学意义（均P>0.05）；但吉非替尼组体液免疫指标IgG和IgA水平高于埃克替尼组（均P<0.05）。结论 埃克替尼和吉非替尼在治疗EGFR突变型晚期肺腺癌患者的临床疗效、不良反应相似。用药后两组细胞免疫功能亦相似，但吉非替尼组治疗后体液免疫IgG和IgA水平略优于埃克替尼组。

关键词: 肺腺癌, 吉非替尼, 埃克替尼, 临床疗效, 免疫功能

Abstract: Objective To compare the clinical efficacy, adverse events, and immunological function status after medication of icotinib and gefitinib in the treatment of advanced lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations. Methods A total of 176 patients with EGFR mutation⁃positive lung adenocarcinoma confirmed by pathological biopsy at Guangxi Medical University Cancer Hospital from January 2012 to December 2019 were selected as the objects of study, and divided into the icotinib group and gefitinib group according to the targeted treatment regimen. The treatment efficacy were evaluated according to the RECIST 1.1 standard. The incidence of adverse reactions, differences of cellular immunity and humoral immunity indexes were compared between the two groups. Results There was no significant difference between icotinib and gefitinib in terms of objective response rate (60.0% vs 63.2%), disease control rate (94.0% vs 92.1%), median progression⁃free survival (9.5 months vs 8.9 months), median overall survival (21.7 months vs 18.5 months ) as well as overall incidence of adverse reactions (31.0% vs 34.2%) (all P>0.05) . There was no significant difference of cellular immune indicators (CD3+T cells, CD4+T cells, CD8+T cells, CD4+/CD8+, natural killer cells) and humoral immune indicator IgM between two groups (all P>0.05). However, the levels of humoral immune indicators IgG and IgA in gefitinib group were higher than those of icotinib group (all P<0.05). Conclusions The clinical efficacy and adverse events of icotinib and gefitinib are similar in the treatment of advanced lung adenocarcinoma patients with EGFR mutation⁃positive. The cellular immune functions of the two groups are also similar, but the levels of humoral IgG and IgA in gefitinib group are slightly higher than those in icotinib group.

Key words: Lung adenocarcinoma, Gefitinib, Icotinib, Clinical efficacy, Immune function

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