Abstract:Objective: To investigate the clinical efficacy and adverse reactions of gefitinib combined with Endostar in the first-line treatment of EGFR mutation positive advanced lung adenocarcinoma. Methods: Sixty patients with lung adenocarcinoma with EGFR exon 19-21 mutation inoperability or postoperative recurrence and metastasis admitted to the Chengdu Fifth People's Hospital from January 2016 to January 2019 were randomized into control group and study group, with 30 cases in each group. Patients in control group were treated with gefitinib alone, while patients in study group were treated with Endostar on the basis of gefitinib, with 21 days as a cycle. Objective response rate (ORR), pain response, tumor markers, adverse drug reactions, progression free survival (PFS) and overall survival (OS) were compared between the two groups. Results: The ORR of the study group was significantly higher than that of the control group (83.33% vs.50.00%, P<0.05). The pain relief degree of the study group was significantly better than that of the control group (P<0.05). The level of tumor markers (serum CEA, CYFRA21-1 and CA199) in the two groups decreased after the treatment, and the study group dropped more significantly than the control group (P<0.05). There were no gradeⅣadverse reactions in both groups. The rash in the study group was less than that in the control group, but there were individual cases of mild bleeding. The mPFS of the control group was 9.18 months (95%CI=7.80-10.56), and the mPFS of the study group was 15.23 months (95%CI=13.07-17.39), with significant differences (P<0.05). The mOS of the control group was 17.98 months (95%CI=14.40-21.57) and that of the study group was 25.95 months (95%CI=20.09-26.17), with significant differences (P<0.05).Further subgroup analysis showed that PFS and OS in the study group were significantly longer than those in the control group, regardless of the mutation in exon 19 or exon 21. Conclusion: Gefitinib combined with Endostar in the first-line treatment of EGFR mutation positive advanced lung adenocarcinoma can effectively improve the clinical efficacy, prolong the survival period of patients, reduce the level of tumor markers, and does not increase the adverse drug reaction rate, with high security, which is worthy of promotion in the first-line treatment of advanced non-small cell lung cancer.
