Efficacy of gefitinib in treatment of epidermal growth factor receptor-positive advanced non-small cell lung cancer / 肿瘤研究与临床

ABSTRACT

Objective:To explore the treatment effect of gefitinib on epidermal growth factor receptor (EGFR)-positive advanced non-small cell lung cancer (NSCLC).Methods:Sixty patients with EGFR-positive advanced NSCLC who were admitted to the 904th Hospital of Joint Logistics Support Force of Chinese PLA from March 2016 to January 2020 were selected. They were divided into gefitinib treatment group (30 cases, treated with gefitinib) and combined treatment group (30 cases, treated with pemetrexed combined with cisplatin) by random number table. The anti-tumor efficacy, levels of tumor markers [serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen (CYFRA21-1) and neuron-specific enolase (NSE)] before and after treatment, adverse reactions and 6-month overall survival (OS) rate were compared between the two groups.Results:The clinical control rate of gefitinib treatment group was higher than that of combined treatment group [76.7% (23/30) vs. 50.0% (15/30), χ2 = 4.593, P = 0.032]. There was no significant difference in the levels of CEA, CYFRA21-1 and NSE between the two groups before treatment (all P > 0.05). The levels of CEA, CYFRA21-1 and NSE after treatment in gefitinib treatment group were (902±41) μg/L, (3.1±0.4) ng/ml and (17.7±2.3) ng/ml. The levels of CEA, CYFRA21-1 and NSE after treatment in combined treatment group were (999±51) μg/L, (4.0±0.5) ng/ml and (19.4±3.1) ng/ml. The levels of CEA, CYFRA21-1 and NSE after treatment in gefitinib treatment group were lower than those in combined treatment group ( t = 7.441, P < 0.01; t = 7.459, P < 0.01; t = 2.486, P = 0.016).The levels of CEA, CYFRA21-1 and NSE after treatment in the two groups were all lower than those before treatment, and the differences were statistically significant (all P < 0.05). There was no significant difference in the incidence of rash, thrombocytopenia, digestive tract reaction, and proteinuria between the two groups [26.7% (8/30) vs. 23.3% (7/30), χ2 = 0.089, P = 0.766; 16.7% (5/30) vs. 13.3% (4/30), χ2 = 0.131, P = 0.718); 30.0% (9/30) vs. 26.7% (8/30), χ2 = 0.082, P = 0.774; 10.0% (3/30) vs. 13.3% (4/30), χ2 = 0.162, P = 0.688]. After 6 months of treatment, the OS rate in gefitinib treatment group was 93.3%, and that in combined treatment group was 83.3%, and there was no statistical difference between the two groups ( χ2 = 1.456, χ2 = 0.228). Conclusion:Gefitinib treatment for EGFR-positive advanced NSCLC patients can enhance the anti-tumor efficacy, reduce the content of tumor markers, and has good safety.