病例报告:一个患有罕见EGFR S768I/V769L化合物突变的患者从阿法替尼布和奥西默提尼布中受益
Qingli Cui1, Jiuzhou Zhao2, Yichen Ma3
1Department of Integrated Traditional Chinese and Western medicine, Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China.
Frontiers in pharmacology
|February 9, 2026
概括
本案例研究检查了一名患有罕见EGFR S768I/V769L突变的非小细胞肺癌 (NSCLC) 的患者. 阿法替尼和奥西米尔替尼显示出临床活性,但需要改进的大脑透药物以获得更好的结果.
科学领域:
- 在瘤学瘤学.
- 遗传学 是一个遗传学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 皮肤上生长因子受体 (EGFR) 氨酸激酶抑制剂 (TKI) 已经改变了非小细胞肺癌 (NSCLC) 的治疗方法.
- 综合的基因组分析识别出了不常见的EGFR突变,如S768I和V769L在第20系外中的突变.
- 关于阿法提尼布对S768I/V769L化合物突变的疗效仍在争论中,没有关于奥西默蒂尼布疗效的数据.
研究的目的:
- 报告一种具有EGFR S768I/V769L化合物突变的NSCLC临床病例.
- 详细介绍这种罕见突变的治疗策略和结果.
- 审查现有文献,以了解更广泛的治疗影响.
主要方法:
- 一名47岁的男性被诊断患有IIIB期肺腺癌.
- 有针对性的下一代测序确定了EGFR外20 S768I/V769L化合物突变.
- 治疗包括化学放射治疗,阿法替尼布,高剂量奥西默提尼布和全脑放射治疗.
主要成果:
- 最初的化学辐射疗法获得了部分反应,随后进展.
- 阿法提尼布稳定了主要瘤13个月,但大脑转移发生了.
- 高剂量的 osimertinib 在大脑转移中产生了部分反应,但发生了进展.
- 总体生存期为26个月,低于单一驱动突变的预期.
结论:
- EGFR S768I/V769L化合物突变表明NSCLC的预后不佳.
- 阿法替尼和奥西默提尼可能对这种突变患者有好处.
- 开发穿透大脑的疗法对于改善生存结果至关重要.
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