Objective: To investigate the clinical efficacy and adverse reactions of gefitinib combined with Endostar in the first-line treatment of EGFR mutation positive advanced lung adenocarcinoma. Methods: Sixty patients with lung adenocarcinoma with EGFR exon 19-21 mutation inoperability or postoperative recurrence and metastasis admitted to the Chengdu Fifth People's Hospital from January 2016 to January 2019 were randomized into control group and study group

with 30 cases in each group. Patients in control group were treated with gefitinib alone

while patients in study group were treated with Endostar on the basis of gefitinib

with 21 days as a cycle. Objective response rate (ORR)

pain response

tumor markers

adverse drug reactions

progression free survival (PFS) and overall survival (OS) were compared between the two groups. Results: The ORR of the study group was significantly higher than that of the control group (83.33% vs.50.00%

P<0.05). The pain relief degree of the study group was significantly better than that of the control group (P<0.05). The level of tumor markers (serum CEA

CYFRA21-1 and CA199) in the two groups decreased after the treatment

and the study group dropped more significantly than the control group (P<0.05). There were no gradeⅣadverse reactions in both groups. The rash in the study group was less than that in the control group

but there were individual cases of mild bleeding. The mPFS of the control group was 9.18 months (95%CI=7.80-10.56)

and the mPFS of the study group was 15.23 months (95%CI=13.07-17.39)

with significant differences (P<0.05). The mOS of the control group was 17.98 months (95%CI=14.40-21.57) and that of the study group was 25.95 months (95%CI=20.09-26.17)

with significant differences (P<0.05).Further subgroup analysis showed that PFS and OS in the study group were significantly longer than those in the control group

regardless of the mutation in exon 19 or exon 21. Conclusion: Gefitinib combined with Endostar in the first-line treatment of EGFR mutation positive advanced lung adenocarcinoma can effectively improve the clinical efficacy

prolong the survival period of patients

reduce the level of tumor markers

and does not increase the adverse drug reaction rate

with high security

which is worthy of promotion in the first-line treatment of advanced non-small cell lung cancer.