Abstract: Objective　To investigate the efficacy and safety of triple chemotherapy with osimertinib, pemetrexed, and bevacizumab in epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC). Methods　The clinical data of 106 patients with EGFR-mutant NSCLC who were diagnosed in Weihai Central Hospital from July 2016 to December 2018 were retrospectively analyzed. The cases in the control group [53 cases, 31 males and 22 females, aged (60.37±3.54) years] were given pemetrexed and bevacizumab, and the cases in the observation group [53 cases, 26 males and 27 females, aged (60.82±3.57) years] were given the combined treatment of osimertinib, pemetrexed, and bevacizumab. The chemotherapy efficacy, serum tumor markers, adverse reactions, and survival rate were compared between the two groups. Independent sample t test and paired t test were used for the measurement data, and χ² test was used for the count data. Results　After treatment, the total effective rate and disease control rate in the observation group were 81.13% (43/53) and 92.45% (49/53), respectively, which were significantly higher than those in the control group [60.38% (32/53) and 77.36% (41/53)], with statistically significant differences (χ²=5.517, 4.711; P=0.019, 0.030). Before treatment, there were no statistically significant differences in the levels of cancer antigen 125 (CA125), keratin 19 fragments (CYFRA21-1), and carcino-embryonic antigen (CEA) between the two groups (all P>0.05); after treatment, the levels of CA125, CYFRA21-1, and CEA in the observation group were (38.69±4.69) U/ml, (2.51±0.52) μg/L, and (17.69±3.19) μg/L, respectively, which were significantly lower than those in the control group [(54.23±5.36) U/ml, (4.91±0.73) μg/L, and (26.73±5.34) μg/L], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=1.485, P=0.223). The 3-year survival rate of the control group was 52.83% (28/53), which was significantly lower than that of the observation group [73.58% (39/53)], with a statistically significant difference (χ²=5.972, P=0.015). Conclusion　The therapeutic effect of triple chemotherapy of osimertinib, pemetrexed, and bevacizumab for patients with EGFR-mutant NSCLC is good, which can improve the patients' prognosis without increasing adverse reactions.

Key words: Osimertinib, Pemetrexed, Bevacizumab, EGFR mutant, Non-small cell lung cancer

摘要： 目的　探讨奥希替尼、培美曲塞、贝伐单抗三联化疗对表皮生长因子受体（EGFR）突变型非小细胞肺癌（NSCLC）的疗效及安全性。方法　对2016年7月至2018年12月威海市中心医院收治并确诊的106例EGFR突变型NSCLC患者临床资料进行回顾性分析，根据资料中患者的治疗方法不同纳入对照组和观察组，各53例。对照组男31例、女22例，年龄（60.37±3.54）岁，给予培美曲塞和贝伐单抗治疗。观察组男26例、女27例，年龄（60.82±3.57）岁，给予奥希替尼、培美曲塞、贝伐单抗联合治疗。比较两组患者化疗疗效、血清肿瘤标志物、不良反应以及预后生存情况。计量资料采用独立样本t检验及配对t检验，计数资料采用χ²检验。结果　治疗后，观察组治疗总有效率和疾病控制率分别为81.13%（43/53）、92.45%（49/53），均明显高于对照组60.38%（32/53）、77.36%（41/53），差异均有统计学意义（χ²=5.517、4.711，P=0.019、0.030）。治疗前，两组患者癌抗原125（CA125）、角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）水平比较，差异均无统计学意义（均P>0.05）；治疗后，观察组CA125、CYFRA21-1、CEA水平分别为（38.69±4.69）U/ml、（2.51±0.52）μg/L、（17.69±3.19）μg/L，均低于对照组（54.23±5.36）U/ml、（4.91±0.73）μg/L、（26.73±5.34）μg/L，差异均有统计学意义（均P<0.05）。两组患者的不良反应发生率比较，差异无统计学意义（χ²=1.485，P=0.223）。对照组患者的3年生存率为52.83%（28/53），明显低于观察组73.58%（39/53），差异有统计学意义（χ²=5.972，P=0.015）。结论　奥希替尼、培美曲塞、贝伐单抗三联化疗对EGFR突变型NSCLC患者的治疗效果好，且不会增加不良反应，同时能够改善患者预后。

关键词: 奥希替尼, 培美曲塞, 贝伐单抗, EGFR突变型, 非小细胞肺癌