JCO:EGFR突变非小细胞肺癌患者接受厄洛替尼辅助治疗可以改善预后

2018-11-29 MedSci MedSci原创

表皮生长因子受体(EGFR)抑制剂在晚期EGFR突变非小细胞肺癌(NSCLC)治疗中具有关键作用,JCO近期发表了一篇文章,研究EGFR突变的早期NSCLC 患者接受辅助厄洛替尼治疗的效果。

表皮生长因子受体(EGFR)抑制剂在晚期EGFR突变非小细胞肺癌NSCLC)治疗中具有关键作用,JCO近期发表了一篇文章,研究EGFR突变的早期NSCLC 患者接受辅助厄洛替尼治疗的效果。

在该II期试验中,患有可切除的IA到IIIA期EGFR 突变NSCLC患者接受标准辅助化疗2年后进行厄洛替尼150mg每天治疗。从2008年1月至2012年5月,患者(N = 100)在7个中心入组; 13%患有IA期疾病,32%患有IB期疾病,11%患有IIA期疾病,16%患有IIB期疾病,28%患有IIIA期疾病。厄洛替尼毒性典型; 没有4级或5级不良事件。40%的患者需要将厄洛替尼剂量减少至每天100毫克和16%的患者减量至每天50毫克。中位随访时间为5.2年,2年DFS为88%(I期96%,II期78%,III期91%)。尚未达到中位DFS和总生存期; 5年DFS为56%,5年总生存率为86%。40例患者出现肿瘤复发,厄洛替尼治疗期间仅4例出现复发。厄洛替尼停药后出现复发的中位时间为25个月。在复发患者中进行了二次活检(n = 24; 60%),只有一例患者检测到T790M突变。大多数复发患者再次接受厄洛替尼治疗,中位持续时间为13个月。

文章最后认为,EGFR突变非小细胞肺癌患者接受厄洛替尼辅助治疗可以改善2年无病生存情况。接受辅助厄洛替尼治疗的患者复发很少,并且复发后再次接受厄洛替尼治疗可以持久获益。

原始出处:

Nathan A. Pennell, Joel W. Neal, et al. SELECT: A Phase II Trial of Adjuvant Erlotinib in Patients With Resected Epidermal Growth Factor Receptor–Mutant Non–Small-Cell Lung Cancer. JCO. November 2018 doi: 10.1200/JCO.18.00131

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    2019-06-24 lidong40
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    2018-12-01 liuyiping
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