Clinical Observation of Crizotinib in the Treatment of ALK Positive Advanced Lung Adenocarcinoma / 中国药房

ABSTRACT

OBJECTIVE： To observe the efficacy and safety of crizotinib in the treatment of anaplastic lymphoma kinase （ALK） positive advanced lung adenocarcinoma. METHODS： From Aug. 2015 to May 2017， 72 patients with ALK positive advanced lung adenocarcinoma were selected from our hospital. According to the simple random method， the patients were divided into control group and observation group， with 36 patients in each group. The control group was given Pemetrexed disodium for injection 500 mg/m2，d1， ivgtt+ Cisplatin for injection 75 mg/m2，d1-3，ivgtt； Dexamethasone acetate tablets 0.75 mg were given orally one day before administration， once in the morning and again in the evening； 7 days before administration， Folic acid tablets 0.4 mg were given orally till 21 days after the last administration of cisplatin； Vitamin B12 1 mg injection was injected intramuscularly every 3 weeks after intramuscular injection of cisplatin. Isotonic Glucose injection 100 g was intravenously dripped 1 day before medication； on the day of chemotherapy， isotonic Sodium chloride injection or Glucose injection was infused intravenously for 3 000-3 500 mL； at the same time， Potassium chloride injection 0.5 g， Mannitol injection 50 g， Furosemide injection 20 mg were given to ensure daily urine volume of 2 000-3 000 mL； a treatment course lasted for 21 d， and there were 2 courses in total. Observation group was additionally given Crizotinib capsules 250 mg orally， once at 7：00 in the morning and evening， swallowing whole capsule， not chewed or dissolved， for 42 days. The clinical efficacies， survival quality and the occurrence of toxic reaction were observed in 2 groups. RESULTS： Total response rate （61.11％） and stable rate of survival quality （83.33％） in observation group were significantly higher than those （27.78％， 44.44％） of control group （P＜0.05）； incidence of grade Ⅰ-Ⅳ myelosuppression， gastrointestinal reaction， abnormal liver function， peripheral neuritis and alopecia in observation group were significantly lower than those of control group； incidence of grade Ⅰ-Ⅳ visual effect in observation group was significantly higher than control group（P＜0.05）. There was no statistical significance in the incidence of edema between 2 groups（P＞0.05）. CONCLUSIONS： Based on routine chemotherapy， additional application of crizotinib can significantly improve therapeutic efficacy of patients with advanced ALK positive lung adenocarcinoma， and effectively improve survival quality of patients without increasing the occurrence of toxic reaction of other tissues or organs， but the incidence of toxic reaction is in high level relatively.