Marked response to nab-paclitaxel in EGFR mutated lung neuroendocrine carcinoma: A case report.
Marked response to nab-paclitaxel in EGFR mutated lung neuroendocrine carcinoma: A case report.
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白蛋白结合型紫杉醇治疗 EGFR 突变肺神经内分泌癌显着疗效一例报告
DOI：
10.1097/md.0000000000006985
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发表时间：
2017-05
期刊：
影响因子：
1.6
通讯作者：
Liu L
中科院分区：
文献类型：
--
作者：
Liang JY;Tong F;Gu FF;Liu YY;Zeng YL;Hong XH;Zhang K;Liu L
肺癌是世界上癌症相关死亡的主要原因。酪氨酸激酶抑制剂（TKI）针对突变的表皮生长因子受体（EGFR），已成为携带 EGFR 突变的晚期肺腺癌的一线治疗方法。 EGFR 突变主要见于肺腺癌。然而，这种情况在肺神经内分泌癌中很少见，治疗策略仍鲜有报道。在此，我们描述了一名 54 岁的中国男性，诊断为肺腺癌（cT4N3M1b，IV 期），伴有神经内分泌分化和外显子 21 上的 L858R 突变。4 个月后，他的肝脏出现进展，肝转移活检显示神经内分泌癌保持了相同的 EGFR 突变。通过活检鉴别肺腺癌和神经内分泌癌。在白蛋白结合型紫杉醇和厄洛替尼联合治疗后，患者获得部分缓解。患者的总生存期为 27 个月。该病例强调 EGFR 突变肺神经内分泌癌对单药 EGFR-TKI 没有反应。但与白蛋白结合型紫杉醇联合应用可以提高其疗效并延长患者的生存期。
Lung cancer is the leading cause of cancer-related death in the world. Tyrosine kinase inhibitors (TKIs), which target mutated epidermal growth factor receptor (EGFR), have been the first-line treatment of late-stage lung adenocarcinoma harboring EGFR mutation. EGFR mutations are mostly identified in lung adenocarcinoma. However, it is rarely seen in lung neuroendocrine carcinoma, and treatment strategies remain under reported. Here, we describe a 54-year-old Chinese man diagnosed with lung adenocarcinoma (cT4N3M1b, stage IV) with neuroendocrine differentiation and L858R mutation on exon 21. He developed progressive disease in liver 4 months later, and the biopsy of liver metastases showed neuroendocrine carcinoma maintained the same EGFR mutation. Lung adenocarcinoma and neuroendocrine carcinoma were identified by biopsy. After a combined treatment with nab-paclitaxel and erlotinib, the patient achieved partial remission. The patient's overall survival was 27 months. This case highlights that EGFR mutated lung neuroendocrine carcinoma is not responsive to single-agent EGFR-TKI. However, combined application with nab-paclitaxel can improve its efficacy and prolong the patient's survival.