目的 评价观察厄洛替尼对吉非替尼耐药的晚期非小细胞肺癌(non small cell lung cancer,NSCLC)腺癌患者的疗效和安全性.方法 分析2008年6月至2009年12月共22例NSCLC腺癌患者,均口服吉非替尼并出现病情进展,改换为厄洛替尼,直到病情进展或不良反应不能耐受为止.观察疗效与不良反应以及疗效与临床特征之间的关系.结果 厄洛替尼治疗22例吉非替尼耐药的进展期NSCLC患者,2例获得部分缓解(partial remission,PR),7例获得稳定(stable disease,SD),客观有效率为9％,疾病控制率为40.9％.获有效和稳定的9例患者中,7例曾在吉非替尼治疗中获益.厄洛替尼治疗的中位疾病进展期(time to progress,TTP)和中位总生存期(overall survival,OS)分别为82 d和192 d.厄洛替尼获益的9例患者较未获益的13例患者获得更长的TTP(112 vs 45.5 d,P＜0.05).厄洛替尼最常见的不良反应为皮疹.结论 厄洛替尼可以作为治疗吉非替尼耐药的进展期NSCLC的药物选择,尤其是对于曾予以吉非替尼治疗可以获益的患者.%Objective To evaluate the efficacy and safety of erlotinib on the advanced adenocarcinoma of non small cell lung cancer (NSCLC) patients after failure of gefitinib treatment and study the relationship between efficacy and clinical characteristics. Methods A retrospective analysis of advanced NSCLC patients who were previously treated with gefitinib and showed progression from June 2008 to February 2009. And the patients received erlotinib 150 mg/d until disease progression or the drug became intolerable because of toxicity. The efficacy, side effects and the relationship between efficacy and the epidermal growth factor receptor ( EGFR) Tyrosine kinase inhibitors (Tki)s and clinical characters were observed. Results A total of 22 NSCLC patients were enrolled in this study. Among 22 patients, two had partial response and seven had a stable disease, resulting in an objective response rate of 9% , and a disease control rate of 40.9%. The overall survival of those who had no benefit vs. Those who had benefit were 82 days and 192 days respectively. The patients who had obtained disease control with erlotinib, showed a longer time to progress (TTP) (112 vs. 45. 5 days, P < 0. 05 ). The most common toxic effects were skin rash and diarrhea. Conclusion Erlotinib seems to be effective in patients with advanced NSCLC after failure of gefitinib, especially in those who had benefit from prior gefitinib treatment.
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