Clinical Observation Of Targeted Drugs As A Therapy On Advanced Non-small Cell Lung Cancer

Background and objectiveLung cancer is one of diseases with the highest morbidity and mortality among malignant tumors, wherein non-small cell lung cancer (NSCLC) takes up 80%-85% of all lung cancer cases[1]. The overall 5-year survival rate of NSCLC is only 12%-15%, and the median survival time of terminally ill patients is about 8-10 months, which hasn’t improved appreciably in the past two decades. In recent years, with the development of cancer molecular targeting therapy, some of new molecular targeted drugs have been introduced to clinical trials and it has achieved remarkable results[2-3].Targeted drugs, especially represented by Gefitinib and Erlotinib-epidermal growth factor receptor tyrosine kinase inhibitor, selectively bind with epidermal growth factor receptor TK Gene site in catalytic area. That can block EGFR-TK conduction and play a significant anti-tumour effect.The purpose of this study is to observe short-term effect and toxic and side effect of target-specific drug EGFR-TKI in treatment of EGFR mutation NSCLC patients.Research MethodsSelected 125 advanced NSCLC patients treated by Gefitinib and Erlotinib, with evaluable therapeutic efficiency. Patients took 250 mg Gefitinib or 150 mg Erlotinib on a daily basis, till appeared, intolerant toxic side effects, disease progression (PD) or death. During the medication, patients had a periodic review of blood routine and liver and renal function, tumour cell and imageological diagnosis regularly. Direct sequencing method was applied for examining tumour tissue EGFR exon 19 and 21 mutation. In accordance with RECIST1.1 standard, a curative effect evaluation was carried out to examine and analyse the impact of target-specific drug treatment upon genetic mutations in patients with advanced non-small cell lung cancer. SPSS version 19.0 was used to assist in analysing the data, and provided relevant statistical output results. Kaplan-Meier method was employed to calculate the median survival period and median PFS. P<0.05 was statistically significant.ResultsIn 125 assessable patients, complete remission rate is 0%,91 patients achieved partial remission with 72.8%,22patients achieved stable disease result with 17.6%, 12patients were in the progression of disease with 9.6%, and overall remission rate was 90.4%. Wherein sex and pathological types, EGFR mutation type had an effect on RR, that is, a better effect was found from female, adenocarcinoma, and EGFR19 exons mutation of patients by targeted drug therapy (P<0.05). No obvious statistical significance was found from patients with or without smoking history, and other chemotherapy or curative effect for brain metastases.The survival analysis indicated that the lack of EGFR mutations in exon 19 patients with median PFS (11.0 months), exon 21 point mutations PFS (9.0 months), the median progression-free time was statistically significant (P=0.025). Women with median PFS (11.0 months) was longer than men with the median PFS (7.0 months) time (P=0.006).