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A Model Predicting Lymph Node Status for Patients with Clinical Stage TlaNO-2MO nonsmall cell lung cancer

Chinese Medical Journal 2017年第4期130卷 398-403页

作者： Ruo-Chuan Zang Bin Qiu Shu-Geng Gao Jie He Department of Thoracic Surgery Peking Union Medical College Cancer Hospital and Chinese Academy of Medical Sciences Beijing 100021 China

Background： Lymph node status of patients with early-stage nonsmall cell lung cancer has an influence on the choice of surgery. To assess the lymph node status more correspondingly and accurately, we evaluated the relationship between the preoperative clinical variables and lymph node status and developed one model for predicting lymph node involvement. Methods： We collected clinical and dissected lymph node information of 474 patients with clinical stage TlaN0-2M0 nonsmall cell lung cancer （NSCLC）. Logistic regression analysis of clinical characteristics was used to estimate independent predictors of lymph node metastasis. The prediction model was validated by another group. Results： Eighty-two patients were diagnosed with positive lymph nodes （17.3%）, and four independent predictors of lymph node disease were identified： larger consolidation size （odds ratio [OR] = 2.356, 95% confidence interval [CI]： 1.517-3.658, P 〈 0.001）, central tumor location （OR = 2.810, 95% CI： 1.545-5.109, P = 0.001 ）, abnormal status of tumor marker （OR = 3.190, 95% CI： 1.797-5.661, P 〈 0.001 ）, and clinical N1-N2 stage （OR = 6.518, 95% CI： 3.242-11.697, P 〈 0.001）. The model showed good calibration （Hosmer-Lemeshow goodness-of-fit, P 〈 0.766） with an area under the receiver operating characteristics curve （AUC） of 0.842 （95% [CI]： 0.797-0.886）. For the validation group, the AUC was 0.810 （95% CI： 0.731-0.889）. Conclusions： The model can assess the lymph node status of patients with clinical stage TlaN0-2M0 NSCLC, enable surgeons perform an individualized prediction preoperatively, and assist the clinical decision-making procedure.

关键词： Carcinoma Diagnosis Lymph Nodes nonsmall cell lung cancer Predictive Models

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Macrophage Inhibitory Cytokine-1 as a Novel Diagnostic and Prognostic Biomarker in Stage I and II nonsmall cell lung cancer

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Chinese Medical Journal 2016年第17期129卷 2026-2032页

作者： Yu-Ning Liu Xiao-Bing Wang Teng Wang Chao Zhang Kun-Peng Zhang Xiu-Yi Zhi Wei Zhang Ke-Lin Sun Department of Thoracic Surgery Detection Center of Tumor Biology Cancer Institute and Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100021 China

Background： Increased level of serum macrophage inhibitory cytokine- 1 （MIC- 1 ）, a member oftransfonning growth thctor-β superfamily, was found in patients with epithelial tumors. This study aimed to evaluate whether serum level of MIC-I can be a candidate diagnostic and prognostic indicator for early-stage nonsmall cell lung cancer （NSCLC）. Methods： A prospective study enrolled 152 patients with Stage I-II NSCLC, who were followed up after surgical resection. Forty-eight patients with benign pulmonary disease （BPD） and 105 healthy controls were also included in the study. Serum M IC- 1 levels were measured using an enzyme-linked immunosorbent assay, and the association with clinical and prognostic features was analyzed. Results： In patients with NSCLC, serum protein levels of M IC-I were significantly increased compared with healthy controls and BPD patients （all P 〈 0.001 ）. A threshold of 1000 pg/ml ofM IC-1 was found in patients with early-stage （Stage 1 and II） NSCLC, with sensitivity and specificity of 70.4% and 99.0%, respectively. The serum levels ofMIC- ] were associated with age （P = 0.001 ）, gender （P = 0.030）, and T stage （P = 0.022）. Serum MIC-1 threshold of 1465 pg/ml was found in patients with poor early outcome, with sensitivity and specificity of 72.2% and 66.1%, respectively. The overall 3-year survival rate of NSCLC patients with high serum levels of MIC-1 （〉I 465 pg/ml） was lower than that of NSCLC patients with low serum MIC-1 levels （77.6% vs. 94.8%）. Multivariate Cox regression survival analysis showed that a high serum level ofMIC- 1 was an independent risk factor lbr reduced overall survival （hazard ratio - 3.37, 95% confidential interval： 1.09-10.42, P = 0.035）. Conclusion： The present study suggested that serum M1C-I may be a potential diagnostic and prognostic biomarker ~cbr patients with early-stage NSCLC.

关键词： Macrophage Inhibitory Cytokine-1 nonsmall cell lung cancer Sensitivity Specificity

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Inhibition of nonsmall cell lung cancer cell Migration by Protein Arginine Methyltransferase 1-small Hairpin RNA Through Inhibiting Epithelial-mesenchymal Transition,Extracellular Matrix Degradation, and Src Phosphorylation In Vitro

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Chinese Medical Journal 2015年第9期128卷 1202-1208页

作者： Ting Zhang Ge Cui Yun-Liang Yao Yue Guo Qi-Chun Wang Xi-Ning Li Wen-Ming Feng Department of Pathology Program in Molecular and Translational Medicine School of Medicine Huzhou University Huzhou Zhejiang 313000 China Department of Pathology Research Center First Affiliated Hospital of Huzhou University Huzhou Zhejiang 313000 China Department of Medical Microbiology and Immunology Program in Molecular and Translational Medicine School of Medicine Huzhou University Huzhou Zhejiang 313000 China

Background：Protein arginine methyltransferases 1 （PRMT1） is over-expressed in a variety of cancers,including lung cancer,and is correlated with a poor prognosis of tumor development.This study aimed to investigate the role of PRMT1 in nonsmall cell lung cancer （NSCLC） migration in vitro.Methods：In this study,PRMT1 expression in the NSCLC cell line A549 was silenced using lentiviral vector-mediated short hairpin RNAs.cell migration was measured using both scratch wound healing and transwell cell migration assays.The mRNA expression levels of matrix metalloproteinase 2 （MMP-2） and tissue inhibitor ofmetalloproteinase 1,2 （TIMP l,2） were measured using quantitative real-time reverse transcription-polymerase chain reaction.The expression levels of protein markers for epithelial-mesenchymal transition （EMT）（E-cadherin,N-cadherin）,focal adhesion kinase （FAK）,Src,AKT,and their corresponding phosphorylated states were detected by Western blot.Results：cell migration was significantly inhibited in the PRMT1 silenced group compared to the control group.The mRNA expression of MMP-2 decreased while TIMP 1 and TIMP2 increased significantly.E-cadherin mRNA expression also increased while N-cadherin decreased.Only phosphorylated Src levels decreased in the silenced group while FAK or AKT remained unchanged.Conclusions：PRMT1-small hairpin RNA inhibits the migration abilities of NSCLC A549 cells by inhibiting EMT,extracellular matrix degradation,and Src phosphorylation in vitro.

关键词： Epithelial-mesenchymal Transition Extracellular Matrix Degradation Migration nonsmall cell lung cancer Protein Arginine Methyltransferases 1 Src

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Assessment on the Efficacy and Safety of Aidi Injection Combined with Vinorelbine and Cisplatin for Treatment of Advanced nonsmall cell lung cancer

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Chinese Medical Journal 2016年第6期129卷 723-730页

作者： Hua-Ye Zhao Hai-Yan Zhou Yan-Ting Warlg Wei Chen Shu-Ya Qi Jun-Ling Cao Guo-Hui Li Department of Clinical Chinese Pharmacy School of Chinese Materia Medica Beijing University of Chinese Medicine Beijing 100029 China Department of Pharmacy Cancer Hospital Chinese Academy of Medical Sciences Beijing 100021 China Department of Pharmacy Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 100700 China

Background： The aim of this study was to assess the efficacy and safety of vinorelbine and cisplatin （NP chemotherapy） alone or in combination with Aidi injection for the treatment of advanced nonsmall cell lung cancer （NSCLC）. Methods： Pertinent publications were identified in PubMed, EMBASE, Cochrane Library, CNKI, CQVIR and Wanfang databases, up to December 8, 2015. After quality assessment of all included randomized controlled trials evaluating Aidi injection combined with NP chemotherapy for the treatment of advanced NSCLC, a meta-analysis was performed by Review Manager 5.2 and STATA 12.0 for statistical analyses. Results： Twelve studies including 509 and 503 cases in the experimental and control groups, respectively, were finally analyzed. The meta-analysis revealed that when cisplatin dose ranging from 20 to 40 mg/m2, combination of Aidi injection and NP chemotherapy was statistically different compared with NP chemotherapy alone in enhancing efficiency （relative risk [RR] = 1.24, 95% confidence interval [C/] [ 1.05-1.47], P = 0.010） and reducing the incidence of Grade II or above nausea and vomiting （RR = 0.49, 95% CI [0.30-0.80], P = 0.005）. Meanwhile, with cisplatin ranging from 80 to 120 mg/m2, no significant differences in efficiency （RR = 1.11, 95% CI [0.87- 1.42], P = 0.390） and Grade II or above nausea and vomiting （RR = 0.88, 95% CI [0.71-1.10], P = 0.260） were obtained. In addition, Aidi injection combined with NP chemotherapy was superior to NP chemotherapy alone in improving the quality of life, alleviating Grade II or above leukopenia and thrombocytopenia. Conclusions： Aidi injection combined with NP chemotherapy can enhance efficiency, improve the quality of life, and decrease adverse effects in patients with advanced NSCLC.

关键词： Aidi Injection Meta-analysis nonsmall cell lung cancer Randomized Controlled Trials

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Spatial metabolomics for evaluating response to neoadjuvant therapy in non-small cell lung cancer patients

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cancer Communications 2022年第6期42卷 517-535页

作者： Jian Shen Na Sun Philipp Zens Thomas Kunzke Achim Buck Verena M.Prade Jun Wang Qian Wang Ronggui Hu Annette Feuchtinger Sabina Berezowska Axel Walch Research Unit Analytical Pathology Helmholtz Zentrum Munchen-German Research Center for Environmental HealthNeuherberg 85764Germany Institute of Pathology University of BernBern 3008Switzerland Graduate School for Health Sciences University of BernMittelstrasse 43Bern 3012Switzerland Center for Excellence in Molecular cell Science Chinese Academy of SciencesShanghai 200031P.R.China Department of Laboratory Medicine and Pathology Institute of PathologyLausanne University Hospital and University of LausanneLausanne 1011Switzerland

Background:The response to neoadjuvant chemotherapy(NAC)differs substantially among individual patients with non-small cell lung cancer(NSCLC).Major pathological response(MPR)is a histomorphological read-out used to assess treatment response and prognosis in patientsNSCLC afterNAC.Although spatial metabolomics is a promising tool for evaluating metabolic phenotypes,it has not yet been utilized to assess therapy responses in patients with NSCLC.We evaluated the potential application of spatial metabolomics in cancer tissues to assess the response to NAC,using a metabolic classifier that utilizes mass spectrometry imaging combined with machine learning.Methods:Resected NSCLC tissue specimens obtained after NAC(n=88)were subjected to high-resolution mass spectrometry,and these data were used to develop an approach for assessing the response to NAC in patients with NSCLC.The specificities of the generated tumor cell and stroma classifiers were validated by applying this approach to a cohort of biologically matched chemotherapy-naive patients with NSCLC(n=85).Results:The developed tumor cell metabolic classifier stratified patients into different prognostic groups with 81.6%accuracy,whereas the stroma metabolic classifier displayed 78.4%accuracy.By contrast,the accuracies of MPR and TNM staging for stratification were 62.5%and 54.1%,respectively.The combination of metabolic and MPR classifiers showed slightly lower accuracy than either individual metabolic classifier.In multivariate analysis,metabolic classifiers were the only independent prognostic factors identified(tumor:P=0.001,hazards ratio[HR]=3.823,95%confidence interval[CI]=1.716-8.514;stroma:P=0.049,HR=2.180,95%CI=1.004-4.737),whereasMPR(P=0.804;HR=0.913;95%CI=0.445-1.874)and TNM staging(P=0.078;HR=1.223;95%CI=0.977-1.550)were not independent prognostic factors.Using Kaplan-Meier survival analyses,both tumor and stroma metabolic classifiers were able to further stratify patients as NAC responders(P<0.001)and non-responders(P<0.001).Conclusions:Our findings in

关键词： cancer metabolism machine learning mass spectrometry imaging metabolic classifier nonsmall cell lung cancer prognosis spatial metabolomics treatment response

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Recent advances in immunotherapy for lung cancer

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cancer Innovation 2023年第1期2卷 18-24页

作者： Qi Wang Chunxia Su Caicun Zhou Department of Oncology Shanghai Pulmonary HospitalTongji UniversityShanghaiChina

lung cancer is the malignant tumor with the highest morbidity andmortality in China, and nonsmall cell lung cancer is a common form oflung cancer. After undergoing chemotherapy and molecular targetedtherapy, the treatment of lung cancer has now fully entered the era ofimmunotherapy. Immunotherapy‐based treatment has become one of thestandard treatments for lung cancer. Immunotherapy has also graduallymoved from the back line to the front line, from advanced to earlypatients. This article focuses on the latest developments in perioperativeand advanced lung cancer immunotherapy, discusses the problems andchallenges at the current stage, and explores new directions for futuredevelopment.

关键词： nonsmall cell lung cancer small cell lung cancer perioperative period late stage new immunotherapy

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Non-small-cell lung cancer with epidermal growth factor receptor L861Q-L833F compound mutation benefits from both afatinib and osimertinib: A case report

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World Journal of Clinical Cases 2021年第27期9卷 8220-8225页

作者： Yao Zhang Ji-Qiao Shen Lin Shao Yan Chen Lei Lei Jia-Lei Wang Department of Medical Oncology Fudan University Shanghai Cancer CenterShanghai 200032China Department of Oncology Shanghai Medical CollegeFudan UniversityShanghai 200032China Institute of Thoracic Oncology Fudan UniversityShanghai 200032China Burning Rock Biotech Guangzhou 510300Guangdong ProvinceChina

BACKGROUND Epidermal growth factor receptor(EGFR)tyrosine kinase inhibitors(TKIs)have been adopted as the standard of care for non-small cell lung cancer(NSCLC)patients harboring EGFR sensitizing mutations.Besides the two common mutations exon 19 deletion and L858R,which together comprise approximately 85%of EGFR mutations in NSCLC,rare EGFR mutations also exist,including point mutations,deletions,and insertions spanning EGFR exons 18-25.However,the responsiveness of uncommon EGFR mutations to EGFR TKIs remains elusive and attracts increasing interest.CASE SUMMARY Herein,we report a 55-year-old male patient with stage IV NSCLC harboring a rare EGFR L833F-L861Q compound mutation in cis.The patient achieved a partial response to first-line treatment with afatinib and a progression-free survival of 10 mo.After afatinib failure,the patient received multiple line treatments with chemotherapy.Upon disease progression,the heavily pretreated patient was treated with osimertinib and bevacizumab,and both lung lesion and brain metastases were stable for more than 3 mo.He had an overall survival of 25 mo.CONCLUSION Our case revealed that both afatinib and the osimertinib+bevacizumab combination demonstrated clinical efficacy in NSCLC harboring an EGFR L833FL861Q compound mutation.The results provide more therapeutic options for patients with rare compound mutations.

关键词： Afatinib Osimertinib Epidermal growth factor receptor L861Q-L833F nonsmall cell lung cancer Case report

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Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small cell lung cancer： A 5-year Single-center Experience

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Chinese Medical Journal 2017年第17期130卷 2027-2032页

作者： Evanthia I Botsa Ioanna L Thanou Aspasia T Papatheodoropoulou Loukas I Thanos First Pediatric Clinic National and Kapodistrian University of Athens Agia Sofia Children&#39 s Hospital Athens 11527 Greece Department of Medical Imaging and Interventional Radiology Sotiria General Hospital for Chest Diseases Athens 11527 Greece

Background：Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients.However,not all patients can undergo surgery;thus,minimally invasive ablation procedures such as radiofrequency ablation （RFA） and microwave ablation （MWA） have gained acceptance as alternative treatment methods.This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography （CT）-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer （NSCLC）.Methods：The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology,General Hospital Sotiria,were retrospectively analyzed.Patients were divided into two groups：RFA group and MWA group according to the therapeutic approaches.Preprocedural blood tests included measurement of international normalized ratio,partial thromboplastin time,and platelet enumeration.A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications.Follow-up was performed with CT or magnetic resonance imaging at 1,3,6 months and 1 year after ablation and every 6 months thereafter.Results：A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis.Self-limited,postablation syndrome occurred in 16/99 （16.1%） of ablation sessions.All procedures were technically successful.Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients.Follow-up imaging at 3 months revealed local tumor progression in 8 （22.8%） patients of the RFA group and 7 （19.4%） patients of MWA group,all of them underwent a second session successfully.The 1-year assessment revealed local recurrence of the ablated tumor in six patients （17.1%） of RFA group and seven patients （19.4%） of MWA group.Among these 71 patients,those with tumor size

关键词： Adrenal Metastasis Microwave nonsmall cell lung cancer Radiofrequency Ablation

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Bevacizumab biosimilar LY01008 compared with bevacizumab(Avastin)as first-line treatment for Chinese patients with unresectable,metastatic,or recurrent non-squamous non-small-cell lung cancer:A multicenter,randomized,double-blinded,phase Ⅲ trial

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cancer Communications 2021年第9期41卷 889-903页

作者： Yuankai Shi Kaijian Lei Yuming Jia Bingqiang Ni Zhiyong He Minghong Bi Xicheng Wang Jianhua Shi Ming Zhou Qian Sun Guolei Wang Dongji Chen Yongqian Shu Lianke Liu Zhongliang Guo Yong Liu Junquan Yang Ke Wang Ke Xiao LinWu Tienan Yi Debin Sun Mafei Kang Tianjiang Ma Yimin Mao Jinsheng Shi Tiegang Tang Yan Wang Puyuan Xing Dongqing Lv Wangjun Liao Zhiguo Luo Bin Wang Xiaohong Wu Xiaoli Zhu Shuhua Han Qisen Guo Rongyu Liu Zhiwei Lu Jianyong Zhang Jian Fang Changlu Hu Yinghua Ji Guolong Liu Hong Lu Dedong Wu Junhong Zhang Shuyang Zhu Zheng Liu Wensheng Qiu Feng Ye Yan Yu Yanqiu Zhao Qinhong Zheng Jun Chen Zhanyu Pan Yiping Zhang Wenjuan Lian Bo Jiang Bo Qiu Guojun Zhang Hua Zhang Yanju Chen Yuan Chen Hongbing Duan Manxiang Li Shengming Liu Lijun Ma Hongming Pan Xia Yuan Xueli Yuan Yulong Zheng Emei Gao Li Zhao Shumin Wang Can Wu Department of Medical Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted DrugsBeijing 100021P.R.China Department of Oncology Yibin Second People’s HospitalYibinSichuan 644000P.R.China Department of Oncology Liuzhou People’s HospitalLiuzhouGuangxi 545006P.R.China Department of Thoracic Oncology Fujian Provincial Cancer HospitalFuzhouFujian 350014P.R.China Oncology Department the First Affiliated Hospital of Bengbu Medical CollegeBengbuAnhui 233030P.R.China Department of Oncology the First Affiliated Hospital of Guangdong Pharmaceutical UniversityGuangzhouGuangdong 510030P.R.China Department of Internal medicine Linyi Cancer HospitalLinyiShandong 276002P.R.China Department of Thoracic Surgery the Affiliated Cancer Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510095P.R.China Department of Internal Medicine-Oncology/Department of thoracic oncology Henan Chest HospitalZhengzhouHenan 450003P.R.China The Second Department of Radiotherapy Wuwei Cancer Hospital of Gansu ProvinceWuweiGansu 730000P.R.China Department of Oncology the People’s Hospital of Jiangsu ProvinceNanjingJiangsu 210000P.R.China Respiratory Medicine Department Shanghai East HospitalShanghai 200120P.R.China The Second Department of Internal Medicine-Oncology Xuzhou Central HospitalXuzhouJiangsu 221009P.R.China Oncology Department Tangshan People’s HospitalTangshanHebei 063001P.R.China Respiratory Medicine Department West China Hospital of Sichuan UniversityChengduSichuan 610041P.R.China Thoracic Surgery the Second Affiliated Hospital of Shantou University Medical CollegeShantouGuangdong 515051P.R.China Internal Medicine-Oncology Hunan Cancer HospitalChangshaHunan 410013P.R.China Department of Oncology Xiangyang Central HospitalXiangyangHubei 441021P.R.China Respiratory Department Lishui Central HospitalLishuiZ

Background:Previous studies have demonstrated the preclinical pharmacological and toxicological consistency,and clinical pharmacokinetic equivalence of bevacizumab biosimilar LY01008 with reference bevacizumab(Avastin).This randomized controlled trial aimed to compare the efficacy and safety of LY01008 with Avastin in first-line treatment of Chinese patients with advanced or recurrent non-squamous non-small cell lung cancer(NSCLC).Methods:StageⅢB-ⅣNSCLC patients with evaluable lesions,good physical status,and adequate organ functions from 67 centers across China were randomized in a ratio of 1:1 to receive LY01008 or Avastin 15 mg/kg intravenously in combination with paclitaxel/carboplatin(combined treatment)for 4-6 cycles,followed by maintenance monotherapy with LY01008 until disease progression,intolerable toxicity,or death.The primary endpoint was objective response rate(ORR)in accordance with Response Evaluation Criteria in Solid Tumors(RECIST)version 1.1 confirmed by independent radiological review committees(IRRC).Secondary endpoints included disease control rate(DCR),duration of response(DoR),progression-free survival(PFS),overall survival(OS),and safety.This study was registered in Clinical Trials.gov(NCT03533127).Results:Between December 15^(th),2017,and May 15^(th),2019,a total of 649 patients were randomized to the LY01008(n=324)or Avastin(n=325)group.As of September 25th,2019 for primary endpoint analysis,589 patients received ORR evaluation,with a median number of combined treatment cycles of 5(range 1-6)andmedian duration of treatment of 3.0(range 0.0-5.1)months.ORRof responseevaluable patients in the LY01008 and Avastin groups were 48.5% and 53.0%,respectively.The stratified ORR ratio was 0.91(90%CI 0.80-1.04,within the prespecified equivalence margin of 0.75-1.33).Up to May 15^(th),2020,with a median follow-up of 13.6(range 0.8-28.4)months,no notable differences in DCR,median DoR,median PFS,median OS,and 1-year OS rate were observed between the LY01008 and Avastin groups.There were no clinically m

关键词： anti-angiogenesis anti-VEGF monoclonal antibody avastin bevacizumab biosimilar nonsmall cell lung cancer LY01008 vascular endothelial growth factor

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lung adenocarcinoma harboring rare epidermal growth factor receptor L858R and V834L mutations treated with icotinib:A case report

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World Journal of Clinical Cases 2020年第17期8卷 3841-3846页

作者： Shu-Sen Zhai Hui Yu Tian-Tian Gu Yan-Xia Li Yan Lei Hai-Yan Zhang Tong-Huan Zhen Yun-Ge Gao Oncology Section PLA Strategic Support Force Characteristic Medical CenterBeijing 100101China cancer Research Institute YuceBioShenzhen 518000Guangdong ProvinceChina

BACKGROUND Epidermal growth factor receptor(EGFR)tyrosine-kinase inhibitors are widely used for the treatment of non-small-cell lung cancer with EGFR mutations.However,patients with rare,even compound EGFR mutations have different responses to EGFR-tyrosine-kinase inhibitors,which bring uncertainty to clinical treatment.CASE SUMMARY A 45-year-old female patient presented with a 3-mo history of cough and white sputum without chest pain.Chest computed tomography revealed lung spaceoccupying lesions and multiple lymphadenectasis.Bronchoscopy and pathology suggested lung adenocarcinoma.Compound variation of EGFR gene(exon 21 L858 R/V834 L)was detected in both tissue and circulating tumor deoxyribonucleic acid samples.As a result of next-generation sequencing and her family’s wishes,the patient was given oral treatment with icotinib hydrochloride(125 mg/d,tid)from March 21,2019 and has achieved stable disease for the last 1 year.CONCLUSION Non-small cell lung adenocarcinoma with EGFR L858 R/V834 L was treated successfully with icotinib,and it may be a new medication treatment option.

关键词： Icotinib hydrochloride Epidermal growth factor receptor L858R/V834L nonsmall cell lung cancer Stable disease Case report

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