EGFR耐药后后续紫杉醇类化疗能改善NSCLC病人生存

Clin Lung Cancer. 2010 Jan;11(1):51-6.
Subsequent chemotherapy improves survival outcome in advanced non-small-cell lung cancer with acquired tyrosine kinase inhibitor resistance.
Kuo CH, Lin SM, Lee KY, Chung FT, Hsieh MH, Fang YF, Yu CT, Kuo HP.
SourceDepartment of Thoracic Medicine, Chang Gung Memorial Hospital, Chang Gung University, School of Medicine, Taipei, Taiwan.

Abstract
BACKGROUND: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) provide promising effect against non-small-cell lung cancer (NSCLC), although most tumors acquire resistance. Our objective was to assess the survival outcome of patients with NSCLC with or without subsequent chemotherapy after acquired TKI resistance.

PATIENTS AND METHODS: A total of 114 patients with pathologically confirmed stage IIIB or IV NSCLC who had had disease control with TKIs were retrospectively reviewed. After acquired TKI resistance, patients received either best supportive care (BSC) only or BSC plus subsequent chemotherapy. Both groups were well balanced in regard to performance status, age, sex, histology subtype, and smoking status.

RESULTS: Sixty-seven patients (58.8%) received subsequent chemotherapy, and 47 patients (41.2%) received BSC only. The median overall survival (OS) and progression-free survival (PFS) from the time of TKI resistance in the subsequent-chemotherapy group (11.2 months and 3.5 months, respectively) were longer than those of the BSC group (3.8 months and 1.5 months, respectively; P < .01). Patients who subsequently received taxane-based chemotherapy exhibited higher a response rate and disease control rate (48.7% and 79.5%, respectively) than patients treated with a nontaxane regimen (21.4% and 53.5%, respectively; P < .05). Overall survival and PFS in patients after taxane-based subsequent chemotherapy (12.7 months and 5.1 months, respectively) were longer than those of patients given a nontaxane regimen (7 months and 1.8 months, respectively; P < .01).

CONCLUSION: This study suggests that acquired TKI resistance should be managed aggressively. The higher antitumor response and survival outcome with a taxane-based regimen in this retrospective study could encourage further prospective investigation to confirm the efficacy of taxane over nontaxane chemotherapy in patients with NSCLC whose disease progresses with EGFR TKI treatment.

哪位高手给翻译一下

林林肺癌。2010年1月;11(1):51-6。
随后的化疗改善了晚期非小细胞肺癌获得性酪氨酸激酶抑制剂耐药的生存结果。
郭琦，林世梅，李基，郑福华，谢美，方一夫，余CT，郭惠普.
台湾台北长庚大学医学院长庚纪念医院胸内科。

摘要
背景：表皮生长因子受体（egfr）酪氨酸激酶抑制剂（tki）对非小细胞肺癌（nsclc）有很好的治疗作用，尽管大多数肿瘤获得耐药。我们的目的是评估获得性TKI耐药后有无后续化疗的NSCLC患者的生存结果。

患者及方法：对114例病理确诊期为iii期或IV期的NSCLC患者进行回顾性分析。在获得TKI耐药后，患者要么只接受最佳支持性护理（bsc）要么接受BSC加随后的化疗。两组在表现状态、年龄、性别、组织学亚型和吸烟状况方面都很平衡。

结果：67例（58.8%）患者接受后续化疗，47例（41.2%）患者仅接受平衡计分卡。随后化疗组（11.2个月、3.5个月）TKI耐药时间的中位总生存率（os）和无进展生存率（pfs）均高于平衡计分卡组（3.8个月、1.5个月）；P < .01)。随后接受紫杉烷类化疗的患者的应答率和疾病控制率（分别为48.7%和79.5%）高于接受非紫杉烷类化疗的患者（分别为21.4%和53.5%）；P < .05)。以紫杉烷为基础的后续化疗后患者（分别为12.7个月和5.1个月）的总体生存期和PFS较非紫杉烷方案患者（分别为7个月和1.8个月）；P < .01)。

结论：本研究提示应积极管理获得性TKI抗性。本回顾性研究以紫杉烷为基础的方案具有更高的抗肿瘤反应和生存结果，可鼓励进一步的前瞻性研究，以确定紫杉烷相对于非紫杉烷化疗对EGFR TKI治疗进展的NSCLC患者的疗效。

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