Lancet oncol:信迪利单抗+IBI305+化疗治疗EGFR TKI治疗后进展的EGFR突变型NSCLC

2022-08-03 MedSci原创 MedSci原创 发表于威斯康星

对于经EGFR酪氨酸激酶抑制剂治疗后进展的EGFR突变的NSCLC患者,信迪利单抗+IBI305+顺铂和培美曲塞疗法通常有效

VEGF抑制剂可以增强免疫疗法的疗效。然而,尽管初始缓解率很高,但几乎所有患者最终都会对EGFR酪氨酸激酶抑制剂产生耐药性。该研究旨在评估信迪利单抗(Sintilimab)±IBI305联合培美曲塞和顺铂相比单用培美曲塞+顺铂治疗局部晚期或转移性EGFR突变的经EGFR酪氨酸激酶抑制剂治疗后病程进展的非小细胞肺癌NSCLC)的疗效性和安全性。

这是一项在我国的52家医院开展的随机、双盲、多中心的3期试验,招募了18-75岁的经EGFR酪氨酸激酶抑制剂治疗后进展的EGFR突变的局部晚期或转移性NSCLC患者,随机(1:1:1)分成三组,予以信迪利单抗(200 mg)+IBI305(15 mg/kg)+培美曲塞(500 mg/m2)和顺铂(75 mg/m2),信迪利单抗+培美曲塞+顺铂,或培美曲塞+顺铂(单化疗)治疗。主要终点是无进展生存期。


两组的无进展生存率

2019年7月11日至2021年7月31日期间,共筛查了936位患者,其中444位被随机分至三组:信迪利单抗+IBI305+化疗组 148位;信迪利单抗+化疗组 145位;单化疗组 151位。截止2021年7月31日中期分析时,中位随访了9.8个月后,与单化疗组相比,信迪利单抗+IBI305+化疗显著延长了患者的中位无进展生存期(中位值 6.9个月 vs 4.3个月; HR 0.46,p<0.0001)。


部分不良反应事件

最常见的3-4级治疗相关不良反应事件有中性粒细胞计数减少(信迪利单抗+IBI305+化疗组 vs 信迪利单抗+化疗组 vs 单化疗组:20% vs 18% vs 18%)、白细胞计数减少(11% vs 8% vs 9%)和贫血(12% vs 7% vs 10%)。

综上,对于经EGFR酪氨酸激酶抑制剂治疗后进展的EGFR突变的NSCLC患者,信迪利单抗+IBI305+顺铂和培美曲塞疗法通常有效,且耐受性良好。

原始出处:

Shun Lu, et al. Sintilimab plus bevacizumab biosimilar IBI305 and chemotherapy for patients with EGFR-mutated non-squamous non-small-cell lung cancer who progressed on EGFR tyrosine-kinase inhibitor therapy (ORIENT-31): first interim results from a randomised, double-blind, multicentre, phase 3 trial. The Lancet Oncology. July 28, 2022. https://doi.org/10.1016/S1470-2045(22)00382-5

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    2023-11-01 ms2000001732596507 来自北京

    免疫

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    2023-01-09 howi
  4. [GetPortalCommentsPageByObjectIdResponse(id=2166040, encodeId=d9742166040d5, content=免疫, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05af8663794, createdName=ms2000001732596507, createdTime=Wed Nov 01 11:38:38 CST 2023, time=2023-11-01, status=1, ipAttribution=北京), GetPortalCommentsPageByObjectIdResponse(id=2041441, encodeId=a7bd20414411e, content=<a href='/topic/show?id=baade55002a' target=_blank style='color:#2F92EE;'>#突变型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75500, encryptionId=baade55002a, topicName=突变型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Apr 03 05:56:48 CST 2023, time=2023-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831623, encodeId=760b1831623de, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 09 10:56:48 CST 2023, time=2023-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040487, encodeId=afdb204048eec, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, 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=Thu Mar 09 16:56:48 CST 2023, time=2023-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866675, encodeId=371118666e567, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sun Jun 04 16:56:48 CST 2023, time=2023-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241537, encodeId=9177124153e22, content=<a href='/topic/show?id=329c2e376fa' target=_blank style='color:#2F92EE;'>#信迪利单抗#</a>用于<a href='/topic/show?id=2493130e1a1' target=_blank style='color:#2F92EE;'>#NSCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27376, encryptionId=329c2e376fa, topicName=信迪利单抗), TopicDto(id=13071, encryptionId=2493130e1a1, topicName=NSCLC)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 14:52:11 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384258, encodeId=4f701384258ef, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534652, encodeId=14711534652f2, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, 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=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1244064, encodeId=eb46124406456, content=lancet上果然牛,感谢梅斯更新及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=younei, createdTime=Tue Aug 02 15:56:48 CST 2022, time=2022-08-02, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2166040, encodeId=d9742166040d5, content=免疫, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05af8663794, createdName=ms2000001732596507, createdTime=Wed Nov 01 11:38:38 CST 2023, time=2023-11-01, status=1, ipAttribution=北京), GetPortalCommentsPageByObjectIdResponse(id=2041441, encodeId=a7bd20414411e, content=<a href='/topic/show?id=baade55002a' target=_blank style='color:#2F92EE;'>#突变型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75500, encryptionId=baade55002a, topicName=突变型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Apr 03 05:56:48 CST 2023, time=2023-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831623, encodeId=760b1831623de, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 09 10:56:48 CST 2023, time=2023-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040487, encodeId=afdb204048eec, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, 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=Thu Mar 09 16:56:48 CST 2023, time=2023-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866675, encodeId=371118666e567, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sun Jun 04 16:56:48 CST 2023, time=2023-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241537, encodeId=9177124153e22, content=<a href='/topic/show?id=329c2e376fa' target=_blank style='color:#2F92EE;'>#信迪利单抗#</a>用于<a href='/topic/show?id=2493130e1a1' target=_blank style='color:#2F92EE;'>#NSCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27376, encryptionId=329c2e376fa, topicName=信迪利单抗), TopicDto(id=13071, encryptionId=2493130e1a1, topicName=NSCLC)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 14:52:11 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384258, encodeId=4f701384258ef, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534652, encodeId=14711534652f2, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, 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=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1244064, encodeId=eb46124406456, content=lancet上果然牛,感谢梅斯更新及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=younei, createdTime=Tue Aug 02 15:56:48 CST 2022, time=2022-08-02, status=1, ipAttribution=)]
    2023-06-04 minlingfeng
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    2022-08-04 lsj628
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    2022-08-04 liuyiping
  9. [GetPortalCommentsPageByObjectIdResponse(id=2166040, encodeId=d9742166040d5, content=免疫, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=05af8663794, createdName=ms2000001732596507, createdTime=Wed Nov 01 11:38:38 CST 2023, time=2023-11-01, status=1, ipAttribution=北京), GetPortalCommentsPageByObjectIdResponse(id=2041441, encodeId=a7bd20414411e, content=<a href='/topic/show?id=baade55002a' target=_blank style='color:#2F92EE;'>#突变型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75500, encryptionId=baade55002a, topicName=突变型)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=21015, createdName=heli0118, createdTime=Mon Apr 03 05:56:48 CST 2023, time=2023-04-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1831623, encodeId=760b1831623de, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Jan 09 10:56:48 CST 2023, time=2023-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2040487, encodeId=afdb204048eec, content=<a href='/topic/show?id=cd5865e036' target=_blank style='color:#2F92EE;'>#EGFR TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, 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=Thu Mar 09 16:56:48 CST 2023, time=2023-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1866675, encodeId=371118666e567, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Sun Jun 04 16:56:48 CST 2023, time=2023-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1241537, encodeId=9177124153e22, content=<a href='/topic/show?id=329c2e376fa' target=_blank style='color:#2F92EE;'>#信迪利单抗#</a>用于<a href='/topic/show?id=2493130e1a1' target=_blank style='color:#2F92EE;'>#NSCLC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=27376, encryptionId=329c2e376fa, topicName=信迪利单抗), TopicDto(id=13071, encryptionId=2493130e1a1, topicName=NSCLC)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=循证小兵, createdTime=Sun Aug 28 14:52:11 CST 2022, time=2022-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1384258, encodeId=4f701384258ef, content=<a href='/topic/show?id=14bb1e503a0' target=_blank style='color:#2F92EE;'>#TKI#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17503, encryptionId=14bb1e503a0, topicName=TKI)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b73f484, createdName=lsj628, createdTime=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1534652, encodeId=14711534652f2, content=<a href='/topic/show?id=22b3e9887e' target=_blank style='color:#2F92EE;'>#GFR#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, 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=Thu Aug 04 03:56:48 CST 2022, time=2022-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1244064, encodeId=eb46124406456, content=lancet上果然牛,感谢梅斯更新及时, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=younei, createdTime=Tue Aug 02 15:56:48 CST 2022, time=2022-08-02, status=1, ipAttribution=)]
    2022-08-02 younei

    lancet上果然牛,感谢梅斯更新及时

    0

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