甲磺酸阿帕替尼治疗一例肺腺癌脑转移患者的疗效分析

Analysis of the Efficacy of Apatinib in the Treatment of Brain Metastases of Lung Adenocarcinoma

摘要: 肺癌是世界上最常见也是恶性程度最高的恶性肿瘤之一，其致死率高居各类恶性肿瘤之首，五年生存率不足20%，其中非小细胞肺癌占其中70%以上，发现时多为晚期，非小细胞肺癌的5年生存率不足6%，患者可以通过选择放化疗得到疾病缓解和生存获益，仍有大部分患者会在末次化疗后的2到3个月内再次出现疾病的进展，特别是对于基因检测阴性的患者，对针对应用此类基因的靶向药物疗效不佳，研究发现新生血管为肿瘤生长提供氧和营养，促进肿瘤的生长，而血管内皮生长因子(VEGF)能激活下游通路刺激血管通过结合血管内皮细胞增生的表皮生长因子受体(VEGFR)，从而导致肿瘤的生长，抗血管生成药物通过抑制抑制血管生成能够抑制肿瘤发生发展和转移，甲磺酸阿帕替尼属于小分子抗血管生成抑制剂，作用于血管表皮生长因子酪氨酸激酶受体，通过抗血管生成来抑制实体肿瘤生长，甲磺酸阿帕替尼对于多线治疗失败的的非小细胞肺癌晚期治疗优确切的疗效，具有较好的耐受性。本文报道1例甲磺酸阿帕替尼作为四线药物治疗晚期非鳞NSCLC脑转移患者。

Abstract: Lung cancer is one of the world’s most common and most malignant tumors. The lethality rate of which is the highest in all types of malignant tumors. The five-year survival rate of it is less than 20%, non-small cell lung cancer accounting for more than 70% of all cases and being diagnosed in the locally advanced stage. The 5-year survival rate of NSCLC is less than 6%. Patients can get relief and survival benefit by chemotherapy. Most patients will get PD in 2 or 3 months after the last chemotherapy, especially for those with negative genetic testing showing dismal efficacy to the application of molecular targeted drugs. Study found that neovascularization provide oxygen and nutrition for the growth of the tumor, to promote its growth. Anti-angiogenic drugs can inhibit tumor from progressing and metastasis by inhibiting angiogenesis. And the vascular epidermal growth factor (VEGF) can activate the downstream pathway to stimulate the proliferation of vessel endothelium via binding vascular epidermal growth factor receptor (VEGFR), thus leading to the growth of tumor. Paclitaxel mesylate is a small molecular anti-angiogenesis inhibitor. It can inhibit solid tumor growth factor tyrosine kinase receptor. Acid apatinib shows excellent efficacy and good tolerance for the advanced NSCLC whose multi-line treatment has been failed. This paper reports a case of apatinib mesylate as a fourth-line drug treatment in patients with advanced non-squamous NSCLC brain metastases.