再次基因检测，结果为E点罕见突变，再次求助大家。

前段时间用妈妈血液做的基因检测结果，显示全阴，只有Vegfr2高表达，发贴求助后得到很多朋友的建议和帮助，让我更加坚强，不再迷茫，谢谢大家了。但由于很多人说血液不准，所以又拿了积液去再次检验，结果是E21突变，但是是L861Q，医生说属于E里面的少数突变，我就感觉跟坐过山车似的，一会高兴一会失落，再次求助大家，我这个是不是用特罗凯要有可能有效啊，还有听说阿法替尼针对这个可能会适合，我再一次迷茫，拜托大家有知道的帮忙建议下，谢谢了。

念平安 发表于 2017-3-18 15:01

                               
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基因公司没有推荐药物给到吗？

给了，就是易瑞沙，凯美钠，特罗凯还有阿法替尼

861Q用特罗凯，阿法替尼

我母亲也是检测全阴，请问你再次检测是检测那些？还是在医院检测吗？

奔跑的兔兔 发表于 2017-3-18 15:40

                               
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861Q用特罗凯，阿法替尼

好的好的，谢谢谢谢

先用特罗凯，一个月后评估，无效用阿法替你，这个突变属于21里的分支

https://www.ncbi.nlm.nih.gov/pubmed/27240419，文献摘要如下
Abstract
Most patients with non-small cell lung cancer (NSCLC) harboring common epidermal growth factor receptor (EGFR) mutations, such as deletions in exon 19 or the L858R mutation in exon 21, respond dramatically to EGFR tyrosine kinase inhibitors (EGFR-TKI), and their sensitivities to various EGFR-TKI have been well characterized. Our previous article showed the in vitro sensitivities of EGFR exon 18 mutations to EGFR-TKI, but little information regarding the sensitivities of other uncommon EGFR mutations is available. First, stable transfectant Ba/F3 cell lines harboring EGFR L858R (Ba/F3-L858R), L861Q (Ba/F3-L861Q) or S768I (Ba/F3-S768I) mutations were created and their drug sensitivities to various EGFR-TKI were examined. Both the Ba/F3-L861Q and Ba/F3-S768I cell lines were less sensitive to erlotinib, compared with the Ba/F3-L858R cell line, but their sensitivities to afatinib were similar to that of the Ba/F3-L858R cell line. The Ba/F3-L861Q cell line was similarly sensitive and the Ba/F3-S768I cell line was less sensitive to osimertinib, compared with the Ba/F3-L858R cell line. The results of western blot analyses were consistent with these sensitivities. Next, similar experiments were also performed using the KYSE270 (L861Q) and KYSE 450 (S768I) cell lines, and their results were compatible with those of the transfectant Ba/F3 cell lines. Our findings suggest that NSCLC harboring the EGFR L861Q mutation might be sensitive to afatinib or osimertinib and that NSCLC harboring the EGFR S768I mutation might be sensitive to afatinib. Overall, afatinib might be the optimal EGFR-TKI against these uncommon EGFR mutations.
阿法替尼应该是可以选择的。

我父亲也是861，易40天，无效，准备试试2992，也准备试试克