天津医药 ›› 2024, Vol. 52 ›› Issue (3): 315-318.doi: 10.11958/20231793

• 临床研究 • 上一篇    下一篇

佐利替尼一线治疗EGFR突变NSCLC伴中枢神经系统转移2例报告

徐丹(), 刘夏, 钟殿胜()   

  1. 天津医科大学总医院肿瘤内科(邮编300052)
  • 收稿日期:2023-11-23 修回日期:2023-12-28 出版日期:2024-03-15 发布日期:2024-03-13
  • 通讯作者: E-mail:zhongdsh@hotmail.com
  • 作者简介:徐丹(1997),女,博士在读,主要从事肺部肿瘤基础临床转化方面研究。E-mail:scczxd@163.com

Frst-line treatment of Zorifertinib in EGFR-mutant NSCLC with CNS metastases: a report of two cases

XU Dan(), LIU Xia, ZHONG Diansheng()   

  1. Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin 300052, China
  • Received:2023-11-23 Revised:2023-12-28 Published:2024-03-15 Online:2024-03-13
  • Contact: E-mail: zhongdsh@hotmail.com

摘要:

目的 探讨佐利替尼一线治疗具有原发表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)伴中枢神经系统转移患者的疗效。方法 2例患者均为一线使用佐利替尼,通过实体瘤的疗效评价标准RECIST v1.1和神经系统肿瘤脑转移RANO-BM标准评估肿瘤治疗反应。结果 病例1基线伴多发脑转移,EGFR exon 19del突变,佐利替尼治疗51.4个月后仍维持肺部病灶部分缓解(PR)、颅内病灶完全缓解(CR)。病例2基线单个脑转移病灶,EGFR exon 19del突变,佐利替尼治疗期间达到肺部病灶PR、颅内病灶CR,13.7个月后肺部疾病进展(PD),新发单个脑转移病灶,综合评效PD。病例1出现3级不良反应,为皮肤干燥,其余主要为皮疹、肝功能异常、腹泻,不良反应总体可控。结论 佐利替尼对EGFR突变NSCLC伴中枢神经系统转移患者有较好的颅内及颅外病灶的控制效果,与EVEREST研究一致,可作为一线初始治疗的选择。

关键词: ErbB受体, 癌, 非小细胞肺, 无进展生存期, 中枢神经系统转移, 佐利替尼

Abstract:

Objective To investigate the efficacy of Zorifertinib in first-line treatment of patients with untreated epidermal growth factor receptor (EGFR) mutation in non-small-cell lung cancer (NSCLC) with central nervous system (CNS) metastases. Methods Two patients received Zorifertinib as first-line treatment. The response of tumor treatment was evaluated by response evaluation criteria in solid tumors version 1.1 (RECEST v1.1) and RANO criteria for brain metastases (RANO-BM). Results Case 1 had EGFR exon 19del mutation and multiple brain metastases at baseline. After 51.4 months of treatment with Zorifertinib, case 1 still maintained partial response (PR) in lung lesions and complete response (CR) in intracranial lesions. Case 2 had EGFR exon 19del mutation and a single brain metastasis at baseline. Case 2 achieved PR in lung lesions and CR in intracranial lesions during the treatment with Zorifertinib. After 13.7 months, lung disease progression (PD) and new single brain metastases occurred. The comprehensive evaluation was PD. Case 1 had three-grade treatment-related adverse events (TRAEs), including dry skin, and other TRAEs were rash, abnormal liver function and diarrhea. The TRAEs were generally controllable. Conclusion Zorifertinib has a good effect on controlling intracranial and extracranial lesions in patients with EGFR-mutated NSCLC with CNS metastases. The efficacy of Zorifertinib is consistent with the EVEREST study. Zorifertinib can be one of the first-line initial treatment options.

Key words: ErbB receptors, carcinoma, non-small-cell lung, progression-free survival, central nervous system metastases, Zorifertinib

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