Clinical research of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province

国际肿瘤学杂志 Pub Date : 2019-07-08 DOI:10.3760/CMA.J.ISSN.1673-422X.2019.07.002

Longxia Chen, Ling Lin, Cuiying Wang, Lin Wang, Donglei He, Jun Feng

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Abstract

Objective To study the clinical application of intercalated combination of osimertinib and docetaxel in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. Methods T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the sou-thern Hainan Province treated at the Third People′s Hospital of Hainan Province from January 2018 to October 2018 were enrolled, and they were divided into intercalated combination of osimertinib and docetaxel group (n=32) and osimertinib group (n=28) according to the treatment. The patients in intercalated combination of osimertinib and docetaxel group received oral osimertinib (80 mg, qd), and received docetaxel (75 mg/m2, repeated in three-week intervals) when taking to tumor progression, and oral osimertinib treatment (80 mg, qd) was maintained until tumor partial response or stable disease after chemotherapy. The patients in osimertinib group received oral osimertinib (80 mg, qd). The patients in both groups received zoledronic acid. The response rate, disease control rate, overall survival (OS) and the incidence of adverse reactions of both groups were contrastively analyzed. Results The response rate of intercalated combination of osimertinib and doceta-xel group (62.5%, 20/32) was higher than that of osimertinib group (35.7%, 10/28), and disease control rate (93.8%, 30/32) was also higher than that of osimertinib group (67.9%, 19/28), with statistically significant differences (χ2=4.286, P=0.038; χ2=6.687, P=0.010). The median OS of intercalated combination of osimertinib and docetaxel group was 10.0 months, which was longer than that of osimertinib group (9.0 months), with statistically significant difference (χ2=5.917, P=0.015). Moreover, the adverse reactions in both groups were all grade Ⅰ or Ⅱ, which could be relieved or improved through symptomatic treatment. Conclusion Intercalated treatment of osimertinib with docetaxel is safe and effective in T790M mutation-positive lung adenocarcinoma patients with bone metastasis in the southern Hainan Province. It can prolong the survival time of patients. Key words: Lung neoplasms; Osimertinib; Docetaxel; Bone metastasis; Southern Hainan Province

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奥希替尼与多西他赛穿插联合治疗海南南部T790M突变阳性肺腺癌骨转移的临床研究

目的探讨奥希替尼联合多西他赛在海南地区T790M突变阳性肺腺癌骨转移患者中的临床应用。方法纳入2018年1月至2018年10月在海南省第三人民医院治疗的海南南部T790M突变阳性肺腺癌骨转移患者，根据治疗情况分为奥西替尼+多西他赛插入联合组(n=32)和奥西替尼组(n=28)。奥西替尼与多西他赛穿插联合组患者口服奥西替尼(80 mg, qd)，当肿瘤进展时口服多西他赛(75 mg/m2, 3周间隔重复)，维持口服奥西替尼治疗(80 mg, qd)，直至化疗后肿瘤部分缓解或病情稳定。奥西替尼组患者口服奥西替尼(80mg, qd)。两组患者均给予唑来膦酸治疗。对比分析两组患者的有效率、疾病控制率、总生存期(OS)及不良反应发生率。结果奥西替尼与多西他素穿插联用组的有效率(62.5%，20/32)高于奥西替尼组(35.7%，10/28)，疾病控制率(93.8%，30/32)也高于奥西替尼组(67.9%，19/28)，差异均有统计学意义(χ2=4.286, P=0.038;χ2 = 6.687,P = 0.010)。奥西替尼与多西他赛穿插联合组的中位生存期为10.0个月，高于奥西替尼组(9.0个月)，差异有统计学意义(χ2=5.917, P=0.015)。两组不良反应均为Ⅰ级或Ⅱ级，均可通过对症治疗得到缓解或改善。结论奥西替尼与多西他赛联合治疗海南南部地区T790M突变阳性肺腺癌骨转移患者安全有效。可以延长患者的生存时间。关键词:肺肿瘤;Osimertinib;多西他赛;骨转移;海南南部

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国际肿瘤学杂志

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