Journal of Korean Traditional Oncology (대한암한의학회지)

Korean Association of Traditional Oncology (대한암한의학회)
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A Case of Patient with Non-Small Cell Lung Carcinoma Treated with Samchilchoongcho-Jung in Conjunction with Crizotinib

비소세포성 폐암환자의 Crizotinib과 삼칠충초정 병용투여 경과관찰 1례

  • Ha, Su jeong (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Song, Si yeon (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Park, So-jung (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Jeon, Hyung-joon (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Lee, Yeon-weol (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Cho, Chong-kwan (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University) ;
  • Yoo, Hwa-seung (East West Cancer Center, Dunsan Korean Medicine Hospital of Dae-Jeon University)
  • 하수정 (대전대학교 둔산한방병원 동서암센터) ;
  • 송시연 (대전대학교 둔산한방병원 동서암센터) ;
  • 박소정 (대전대학교 둔산한방병원 동서암센터) ;
  • 전형준 (대전대학교 둔산한방병원 동서암센터) ;
  • 이연월 (대전대학교 둔산한방병원 동서암센터) ;
  • 조종관 (대전대학교 둔산한방병원 동서암센터) ;
  • 유화승 (대전대학교 둔산한방병원 동서암센터)
  • Published : 2018.06.30
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Abstract

Objective: The purpose of this study is to report the case of a patient with non-small cell lung adenocarcinoma (NSCLC) with anaplastic lymphoma kinase (ALK) mutation treated by Samchilchoongcho-Jung in conjunction with Crizotinib. Methods: An NSCLC patient diagnosed with multiple pleural and lymph nodes metastasis has been taking Crizotinib (500 mg/day) since January 2014. The patient has been treated with Samchilchoongcho-Jung (1,500 mg/day) since June 2014. The tumor size was measured by computed tomography (CT) and laboratory analysis was conducted. Adverse events were evaluated by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: After combining treatment, stable disease was shown on CT. The tumor marker (CEA, Cyfra 21-1) levels were maintained. NCI-CTCAE 5.0 showed no adverse events. Conclusion: This case study suggests that Samchilchoongcho-Jung may contribute to tumor response, in conjunction with Crizotinib on the treatment of patients with NSCLC.

ALK 변이는 비소세포성 폐암에서 차지하는 비율은 높지 않지만 비소세포성 폐암의 발생률이 높기 때문에 환자 수는 적지 않다. ALK 저해제인 Crizotinib은 환자들의 무진행 생존을 평균 대략 4개월 정도 연장시키고 증상을 완화시키며 항암 치료를 받는 것에 비교하여 삶의 질을 향상시키는 치료성과를 거두었다. 하지만 약물 내성 발현은 주요 한계이며 여전히 ALK 변이 비소세포성 폐암 환자의 예후가 불량하므로 내성을 극복하고 지속적인 치료 반응을 유도하여 치료율을 상승시키기 위한 연구가 필요하다. 현재 폐암치료 한약제제인 삼칠충초정과 2세대 EGFR TKI 제제인 Afatinib의 동시 사용 시 상승효과가 나타난다는 연구결과는 보고되어 있지만 ALK 저해제인 Crizotinib과의 병용 치료와 관련한 연구는 시행된 바가 없었다. 본 증례는 삼칠충초정과 Crizotinib의 병용 투여를 통해 종양 크기의 불변 및 삶의 질 개선과 Crizotinib의 내성 억제 가능성 등을 보인 점에서 의의가 있으나 대조군이 없는 1례에 불과하여 Crizotinib의 단독 효과일 가능성을 배제할 수 없는 한계를 지닌다. 따라서 향후 삼칠충초정과 Crizotinib의 병용투여에 대한 추가적인 연구 및 임상시험을 통해 더욱 객관적인 효과 판정이 필요할 것으로 사료된다.

Keywords

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