Comparative analysis of the clinical efficacies of furmonertinib and gefitinib in the treatment of advanced EGFR-mutated non-small cell lung cancer
Objective To explore the efficacies and safeties of furmonertinib and gefitinib in the treatment of advanced non-small cell lung cancer(NSCLC)with epidermal growth factor receptor(EGFR)sensitive mutations.Methods This study was a prospective,randomized,controlled,and single-center clinical study.A total of 90 patients with advanced NSCLC admitted to Shangluo Central Hospital from April 2021 to April 2022 were selected and were divided into an experimental group and a control group according to the random number table method.In the experimental group,45 cases were screened,2 cases were excluded,and 43 cases were finally included in the analysis,including 29 males and 14 females,aged(51.79±6.28)years,and 43 cases of adenocarcinoma.In the control group,45 cases were screened,3 cases were excluded,and 42 cases were finally included in the analysis,including 26 males and 16 females,aged(52.06±5.41)years,and 42 cases of adenocarcinoma.Both groups were treated with pemetrexed 500 mg/m2 intravenously,once every 21 days,on the first day of each treatment cycle.The control group was treated with gefitinib tablets,250 mg each time,once a day,21 days as 1 treatment cycle.The experimental group was treated with oral furmonertinib mesylate tablets,40 mg each time,twice a day,21 days as 1 treatment cycle.Both groups were treated for 3 cycles.The carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),cytokeratinin-19 fragment antigen 21-1(CYFRA21-1),matrix metalloproteinase-9(MMP-9),tissue inhibitor of metalloproteinase-1(TIMP-1),efficacy,and safety were compared between the two groups.The patients were followed up for 18 months,and the survival prognosis was recorded.Independent sample t test,paired t test,and x2 test were used.Results After treatment,the total effective rates of the experimental group and the control group were 69.77％(30/43)and 47.62％(20/42),respectively,with a statistically significant difference(x2=4.303,P=0.038).After treatment,the CEA levels in the experimental group and the control group were(20.21±5.72)and(25.31±4.16)μg/L,the CA19-9 levels were(26.85± 3.92)and(29.62±4.15)μg/L,the CYFRA21-1 levels were(2.61±0.76)and(3.62±0.91)μg/L,the MMP-9 levels were(102.86±20.37)and(117.41±22.06)μg/L,and the TIMP-1 levels were(608.31± 60.43)and(635.93±61.15)μg/L,with statistically significant differences(all P＜0.05).The total incidence of adverse drug reactions in the experimental group and the control group were 39.53％(17/43)and 30.95％(13/42),respectively(x2=0.685,P=0.408).At the end of follow-up,2 patients in the experimental group were lost to follow-up,the median progression-free survival(PFS)was 8 months,and 8 patients died.In the control group,2 patients were lost to follow-up,the median PFS was 14 months,and 17 patients died.Median overall survival(OS)was not achieved in both groups,and the difference in the OS survival curve between the two groups was statistically significant(Log-rankx2=4.939,P=0.026).Conclusion Compared to gefitinib,furmonertinib is more helpful in improving the disease remission rate and prolonging the PFS and OS in the treatment of advanced NSCLC,with good safety.
万方数据
维普
