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2018WCLC:逆转耐药,EGFR TKIs耐药后联用阿帕替尼的临床价值再探索

2018-09-30 佚名 肿瘤资讯

EGFR-TKI类药物的出现显着改善了NSCLC突变阳性患者的预后,但缓解时间有限,平均持续10个月左右。EGFR-TKIs的治疗耐药问题是突变阳性患者治疗的难题。既往有一项基础研究和两项临床研究的SCI文献显示,一线使用EGFR-TKI出现进展后,继续使用阿帕替尼联合EGFR-TKIs能延缓TKIs耐药,得到良好的再次缓解时间。2018年在加拿大多伦多召开的WCLC会议上,有13项阿帕替尼的相关

EGFR-TKI类药物的出现显着改善了NSCLC突变阳性患者的预后,但缓解时间有限,平均持续10个月左右。EGFR-TKIs的治疗耐药问题是突变阳性患者治疗的难题。既往有一项基础研究和两项临床研究的SCI文献显示,一线使用EGFR-TKI出现进展后,继续使用阿帕替尼联合EGFR-TKIs能延缓TKIs耐药,得到良好的再次缓解时间。2018年在加拿大多伦多召开的WCLC会议上,有13项阿帕替尼的相关研究壁报交流的形式入围,其中两项研究报道了阿帕替尼在一线EGFR-TKIs治疗进展后进行联用的疗效和安全性。有幸邀请到东部战区总医院宋勇教授就EGFR TKIs耐药后NSCLC的治疗现状、阿帕替尼联合EGFR TKIs在晚期NSCLC中的应用前景在大会现场进行专访。

研究概况

1.宋霞教授-阿帕替尼联合EGFR TKI治疗EGFR TKI耐药后进展NSCLC的有效性和安全性研究

EGFR突变型晚期NSCLC患者接受EGFR-TKIs治疗后易出现耐药。既往有研究显示,阿帕替尼(靶向VEGFR-2的小分子TKI)联合EGFR-TKIs可以改善EGFR-TKIs耐药NSCLC患者的预后。本研究旨在评价阿帕替尼联合EGFR-TKIs相比于传统化疗对于EGFR-TKIs耐药NSCLC患者的疗效和安全性。

本研究入组患者均为EGFR-TKIs耐药型晚期NSCLC患者。患者接受阿帕替尼联合EGFR-TKIs(阿帕替尼初始剂量为250mg+EGFR TKIs的既往剂量)或化疗(培美曲塞或长春瑞滨联合铂类)。疗效评估采用RECIST1.1标准,每6周评价1次疗效。

自2017年3月至2018年5月期间,本研究共入组24例患者:18例接受阿帕替尼联合EGFR-TKIs治疗,6例接受化疗治疗。在阿帕替尼联合组,83.33%(15/18)的患者可以进行疗效评估,ORR率为20%(3/15),DCR率为100%(15/15),所有患者均有不同程度的病灶缩小。至2018年5月1日,阿帕替尼组的中位治疗时间为187天,中位PFS尚未达到。2例接受奥希替尼治疗失败的患者接受奥希替尼联合阿帕替尼治疗,治疗1周期后病灶缩小。2例患者中,其中1例患者为5线治疗。阿帕替尼联合组2例合并脑转移的患者治疗后出现颅内病灶缩小。2例患者在出现疾病进展后增加阿帕替尼剂量至500mg时病灶再次缩小。

阿帕替尼联合组最常见的不良事件为高血压、蛋白尿和乏力。5例(27.78%)患者出现3度高血压,3例(16.67%)患者出现3度蛋白尿,1例(5.56%)患者出现3度腹泻。化疗组的主要的不良反应为消化道反应和骨髓抑制。

上述研究结果显示,阿帕替尼联合EGFR TKIs为EGFR TKIs耐药的NSCLC患者提供了新的治疗策略。两种药物均可以口服,改善了患者的生活质量和治疗依从性。上述研究结果有待于更大样本量研究的证实,后续研究中也将会进一步探索基因突变、肿瘤标志物与治疗疗效之间的关系。

2.陈明达、孙国贵教授-低剂量阿帕替尼联合EGFR TKI对于一代TKIs治疗进展后晚期NSCLC的疗效和安全性分析

本研究为一项回顾性分析,旨在评估低剂量阿帕替尼联合EGFR TKIs治疗一代EGFR TKIs进展后晚期NSCLC的临床疗效和安全性,并对潜在的作用机制进行探索。

自2016年3月至2016年11月期间,共入组11例既往接受过厄洛替尼、吉非替尼或埃克替尼治疗后耐药的NSCLC患者,所有患者均接受原EGFR-TKI药物联合阿帕替尼(250mg/天)方案治疗,每4周进行1次CT扫描评估,同时观察药物相关的不良事件。

研究结果显示,入组的11例患者中,有10例可以进行疗效和安全性评估。在第12周时,10例患者中2例患者为PD,另外8例患者表现为SD且仍在接受治疗,DCR率为80%,12周PFS率为72.73%。

最常见的治疗相关不良事件(AEs)为乏力(20%,2/10)、皮疹(20%,2/10)和食欲减退(20%,2/10)。严重AEs包括3度蛋白尿(10%,1/10)。

上述研究表明,低剂量阿帕替尼联合原EGFR-TKI药物用于一代EGFR TKIs治疗后耐药的晚期NSCLC患者显示出较好的疗效,且毒性可以耐受。其作用机制可能为阿帕替尼调节肿瘤微环境并能逆转多种药物的耐药。

专家点评

宋勇教授、主任医师 东部战区总医院呼吸内科主任,肺癌综合诊治中心主任 南京大学呼吸病学研究所所长 南京大学、南京医科大学、南方医科大学、第二军医大学博士及硕士研究生导师 、东部战区总医院博士后联系导师 全军呼吸内科专业委员会副主任委员 江苏省医学会呼吸病分会副主任委员兼肺癌学组组长 中华医学会呼吸病学分会全国委员 中国临床肿瘤学会(CSCO)理事 中国抗癌协会肺癌专业委员会常务委员 肺癌MDT专家委员会副组长 国际肺癌研究组织(IASLC)委员 中央军委保健委员会会诊专家《Translational lung cancer research》杂志(ESCI, PubMed收录)主编,《Journal of Thoracic Disease》杂志(SCI)和《Military Medical Research》杂志(PubMed收录)编委,以及《医学研究生学报》、《中国肺癌杂志》、《中华肺部疾病杂志》、 《中华医学杂志》等多本杂志的副主编和编委

EGFR TKIs耐药NSCLC的治疗现状

关于EGFR TKI耐药以后的治疗,通常分为两种情况。对于一、二代TKI耐药以后存在T790M突变的NSCLC患者,常规推荐三代TKI治疗。三代TKI耐药以后的治疗和一、二代TKI耐药后的治疗方式是有所差异的。截至目前为止,除了一、二代TKI耐药后存在T790M突变、有其他驱动基因和药物可及性的NSCLC,化疗都是这类患者的常规治疗模式。除了化疗以外,EGFR TKI耐药NSCLC患者还可以做一些新的尝试,诸如联合抗血管生成治疗或免疫治疗。但是免疫治疗尤其是免疫检查点抑制剂治疗对于EGFR突变型患者疗效一般。总体来讲,化疗在EGFR TKI耐药NSCLC患者治疗中仍占据重要一席。

阿帕替尼联合EGFR TKI治疗TKI耐药NSCLC患者的研究

本次大会共入选两项类似设计的研究,其中一项研究是由山西省肿瘤医院宋霞教授主持的,研究共入组了24例患者,均为一代、二代或三代TKI耐药的NSCLC患者。这部分患者被分为两组:一组18例患者,在TKI耐药以后继续接受TKI联合阿帕替尼治疗;另外一组6例患者接受化疗治疗。初步研究结果令人倍受鼓舞,对于TKI耐药NSCLC患者,继续接受TKI联合阿帕替尼治疗,有效率20%,疾病控制率甚至达到100%,尽管接受化疗治疗组患者的样本量较小,其有效率仍可以达到17%左右。总体来讲,TKI继续治疗联合阿帕替尼对于TKI耐药NSCLC是一种不错的治疗选择。

血管生成治疗联合EGFR TKI在NSCLC中的应用前景

宋勇教授:近年来EGFR-TKIs联合抗血管生成治疗是一种重要的研究和应用策略,且已有众多的临床研究证据。无论早期的II期临床研究,亦或是今年ASCO刚发表的III期临床研究,均表明抗血管生成治疗联合TKI可以有效改善患者的PFS。从作用机制来讲,TKI药物主要针对肿瘤细胞,抗血管生成治疗药物主要针对肿瘤微环境,尤其是可以让肿瘤中新生血管减少、使得肿瘤血管正常化。因此,EGFR TKI与抗血管生成药物之间可能会有良好的协同作用。另外,EGFR TKI和抗血管生成治疗在信号通路方面也存在cross-talk。抗血管生成治疗联合EGFR TKI兼具理论和临床实践可行性,有望成为一种标准治疗或者新型治疗选择。

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    2019-01-28 yhj-time
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  4. [GetPortalCommentsPageByObjectIdResponse(id=1795738, encodeId=33a21e95738bb, content=<a href='/topic/show?id=2f311e504f6' target=_blank style='color:#2F92EE;'>#TKIs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17504, encryptionId=2f311e504f6, topicName=TKIs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Mon Jan 28 19:43:00 CST 2019, time=2019-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993536, encodeId=763e199353653, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/vLodSSFTQLpHtfwJicWJibSWH7pbiauxvpCMvQIv0N9Oes8vHkDkCIW2HNDkt7icUq3RCZiaDcHR9Rap17fFySRbiaFg/132, createdBy=9f202500205, createdName=ms3297076796458174, createdTime=Sun Mar 17 03:43:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040480, encodeId=7b112040480e9, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6570, encryptionId=cd5865e036, topicName=EGFR TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c66088, createdName=gao_jian4217, createdTime=Sat Oct 27 13:43:00 CST 2018, time=2018-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1814262, encodeId=8250181426216, content=<a href='/topic/show?id=bf0a94e6839' target=_blank style='color:#2F92EE;'>#逆转耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94768, encryptionId=bf0a94e6839, topicName=逆转耐药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sat Jan 05 14:43:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384191, encodeId=680013841913c, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412363, encodeId=a2c014123634b, content=<a href='/topic/show?id=de711863ed3' target=_blank style='color:#2F92EE;'>#WCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18637, encryptionId=de711863ed3, topicName=WCLC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91252863770, createdName=木头人514, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534395, encodeId=40d11534395a7, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347436, encodeId=b46134e43639, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Sep 30 21:59:09 CST 2018, time=2018-09-30, status=1, ipAttribution=)]
    2019-01-05 nymo
  5. [GetPortalCommentsPageByObjectIdResponse(id=1795738, encodeId=33a21e95738bb, content=<a href='/topic/show?id=2f311e504f6' target=_blank style='color:#2F92EE;'>#TKIs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17504, encryptionId=2f311e504f6, topicName=TKIs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Mon Jan 28 19:43:00 CST 2019, time=2019-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993536, encodeId=763e199353653, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/vLodSSFTQLpHtfwJicWJibSWH7pbiauxvpCMvQIv0N9Oes8vHkDkCIW2HNDkt7icUq3RCZiaDcHR9Rap17fFySRbiaFg/132, createdBy=9f202500205, createdName=ms3297076796458174, createdTime=Sun Mar 17 03:43:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040480, encodeId=7b112040480e9, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6570, encryptionId=cd5865e036, topicName=EGFR TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c66088, createdName=gao_jian4217, createdTime=Sat Oct 27 13:43:00 CST 2018, time=2018-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1814262, encodeId=8250181426216, content=<a href='/topic/show?id=bf0a94e6839' target=_blank style='color:#2F92EE;'>#逆转耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94768, encryptionId=bf0a94e6839, topicName=逆转耐药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sat Jan 05 14:43:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384191, encodeId=680013841913c, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412363, encodeId=a2c014123634b, content=<a href='/topic/show?id=de711863ed3' target=_blank style='color:#2F92EE;'>#WCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18637, encryptionId=de711863ed3, topicName=WCLC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91252863770, createdName=木头人514, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534395, encodeId=40d11534395a7, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347436, encodeId=b46134e43639, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Sep 30 21:59:09 CST 2018, time=2018-09-30, status=1, ipAttribution=)]
    2018-10-02 lsj628
  6. [GetPortalCommentsPageByObjectIdResponse(id=1795738, encodeId=33a21e95738bb, content=<a href='/topic/show?id=2f311e504f6' target=_blank style='color:#2F92EE;'>#TKIs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17504, encryptionId=2f311e504f6, topicName=TKIs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Mon Jan 28 19:43:00 CST 2019, time=2019-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993536, encodeId=763e199353653, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/vLodSSFTQLpHtfwJicWJibSWH7pbiauxvpCMvQIv0N9Oes8vHkDkCIW2HNDkt7icUq3RCZiaDcHR9Rap17fFySRbiaFg/132, createdBy=9f202500205, createdName=ms3297076796458174, createdTime=Sun Mar 17 03:43:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040480, encodeId=7b112040480e9, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6570, encryptionId=cd5865e036, topicName=EGFR TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c66088, createdName=gao_jian4217, createdTime=Sat Oct 27 13:43:00 CST 2018, time=2018-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1814262, encodeId=8250181426216, content=<a href='/topic/show?id=bf0a94e6839' target=_blank style='color:#2F92EE;'>#逆转耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94768, encryptionId=bf0a94e6839, topicName=逆转耐药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sat Jan 05 14:43:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384191, encodeId=680013841913c, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412363, encodeId=a2c014123634b, content=<a href='/topic/show?id=de711863ed3' target=_blank style='color:#2F92EE;'>#WCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18637, encryptionId=de711863ed3, topicName=WCLC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91252863770, createdName=木头人514, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534395, encodeId=40d11534395a7, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347436, encodeId=b46134e43639, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Sep 30 21:59:09 CST 2018, time=2018-09-30, status=1, ipAttribution=)]
    2018-10-02 木头人514
  7. [GetPortalCommentsPageByObjectIdResponse(id=1795738, encodeId=33a21e95738bb, content=<a href='/topic/show?id=2f311e504f6' target=_blank style='color:#2F92EE;'>#TKIs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17504, encryptionId=2f311e504f6, topicName=TKIs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Mon Jan 28 19:43:00 CST 2019, time=2019-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993536, encodeId=763e199353653, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/vLodSSFTQLpHtfwJicWJibSWH7pbiauxvpCMvQIv0N9Oes8vHkDkCIW2HNDkt7icUq3RCZiaDcHR9Rap17fFySRbiaFg/132, createdBy=9f202500205, createdName=ms3297076796458174, createdTime=Sun Mar 17 03:43:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040480, encodeId=7b112040480e9, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6570, encryptionId=cd5865e036, topicName=EGFR TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c66088, createdName=gao_jian4217, createdTime=Sat Oct 27 13:43:00 CST 2018, time=2018-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1814262, encodeId=8250181426216, content=<a href='/topic/show?id=bf0a94e6839' target=_blank style='color:#2F92EE;'>#逆转耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94768, encryptionId=bf0a94e6839, topicName=逆转耐药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sat Jan 05 14:43:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384191, encodeId=680013841913c, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412363, encodeId=a2c014123634b, content=<a href='/topic/show?id=de711863ed3' target=_blank style='color:#2F92EE;'>#WCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18637, encryptionId=de711863ed3, topicName=WCLC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91252863770, createdName=木头人514, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534395, encodeId=40d11534395a7, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347436, encodeId=b46134e43639, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Sep 30 21:59:09 CST 2018, time=2018-09-30, status=1, ipAttribution=)]
    2018-10-02 liuyiping
  8. [GetPortalCommentsPageByObjectIdResponse(id=1795738, encodeId=33a21e95738bb, content=<a href='/topic/show?id=2f311e504f6' target=_blank style='color:#2F92EE;'>#TKIs#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17504, encryptionId=2f311e504f6, topicName=TKIs)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=37d0457, createdName=yhj-time, createdTime=Mon Jan 28 19:43:00 CST 2019, time=2019-01-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993536, encodeId=763e199353653, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/vLodSSFTQLpHtfwJicWJibSWH7pbiauxvpCMvQIv0N9Oes8vHkDkCIW2HNDkt7icUq3RCZiaDcHR9Rap17fFySRbiaFg/132, createdBy=9f202500205, createdName=ms3297076796458174, createdTime=Sun Mar 17 03:43:00 CST 2019, time=2019-03-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040480, encodeId=7b112040480e9, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=111, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=6570, encryptionId=cd5865e036, topicName=EGFR TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c66088, createdName=gao_jian4217, createdTime=Sat Oct 27 13:43:00 CST 2018, time=2018-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1814262, encodeId=8250181426216, content=<a href='/topic/show?id=bf0a94e6839' target=_blank style='color:#2F92EE;'>#逆转耐药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94768, encryptionId=bf0a94e6839, topicName=逆转耐药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=560d188, createdName=nymo, createdTime=Sat Jan 05 14:43:00 CST 2019, time=2019-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384191, encodeId=680013841913c, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1412363, encodeId=a2c014123634b, content=<a href='/topic/show?id=de711863ed3' target=_blank style='color:#2F92EE;'>#WCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=18637, encryptionId=de711863ed3, topicName=WCLC)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=91252863770, createdName=木头人514, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534395, encodeId=40d11534395a7, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7988, encryptionId=22b3e9887e, topicName=GFR)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0a812532020, createdName=liuyiping, createdTime=Tue Oct 02 12:43:00 CST 2018, time=2018-10-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=347436, encodeId=b46134e43639, content=了解一下,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Sun Sep 30 21:59:09 CST 2018, time=2018-09-30, status=1, ipAttribution=)]
    2018-09-30 天地飞扬

    了解一下,谢谢分享!

    0

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