Thorac Cancer:EGFR敏感突变NSCLC患者一线阿法替尼,吉非替尼或厄洛替尼治疗的生存获益比较

2022-06-12 yd2015 网络

一线阿法替尼序贯奥希替尼较吉非替尼或厄洛替尼序贯奥希替尼改善EGFR突变患者的OS。

表皮生长因子受体酪氨酸激酶抑制剂(EGFRTKIs)被推荐作为晚期EGFR敏感突变的非小细胞肺癌(NSCLC)患者的一线治疗。有报道称,连续使用不同EGFR- TKIs可改善EGFR突变的NSCLC患者的总生存期。关于一线使用阿法替尼、吉非替尼或厄洛替尼,然后使用奥希替尼治疗获得性T790M突变的方案比较报道有限。近期,有相关结果发表在Thoracic Cancer杂志上。

该研究是一项回顾性队列研究,患者一线接受吉非替尼、厄洛替尼或阿法替尼治疗,进展后获得T79M突变时接受奥希替尼治疗。比较不同EGFR-TKI一线患者的总生存期(OS)、无进展生存期(PFS)和至第二次客观疾病进展时间(PFS2)的差异。

研究纳入155例患者,其中19外显子缺失84例(54.2%),21外显子L858R突变71例(45.8%)。101例(65.2%)、38例(24.5%)和16例(10.3%)患者分别在一线使用吉非替尼、厄洛替尼和阿法替尼。

与吉非替尼或厄洛替尼相比,一线接受阿法替尼治疗的患者OS明显更长。阿法替尼、吉非替尼、厄洛替尼治疗患者的中位OS分别为59.2个月,44.6个月和48.6个月。与吉非替尼相比较,HR为0.407 (95% CI: 0.176–0.943, p = 0.036);与厄洛替尼相比较,HR为0.739 (95%CI: 0.176–1.251, p = 0.261)。

阿法替尼组患者的中位PFS1时间长于吉非替尼或厄洛替尼组,分别为18.8个月(CI = 8.2-29.4)、10.4个月(CI = 8.4-12.4)和13.0个月(CI = 11.5 -14.5)。阿法替尼和厄洛替尼分别与吉非替尼比较时,HR分别为0.601 (95% CI: 0.353 1.023, p = 0.061)和0.995 (95% CI: 0.684 1.450, p = 0.981)。

阿法替尼组患者的中位PFS2时间长于吉非替尼和厄洛替尼组,分别为38.1个月(CI: 18.1-58.1)、25.5个月(CI:18.4-35.6)和24.1个月(CI: 13.0-35.2)。然而,这些结果没有达到统计学意义,当阿法替尼和厄洛替尼分别与吉非替尼比较时,HR分别为0.34 (95% CI: 0.414 1.358, p = 0.341)和1.052 (95% CI: 0.685 1.617, p = 0.817)。

一线使用阿法替尼的患者比一线使用吉非替尼和厄洛替尼的患者更容易发生3级皮肤不良反应和3级胃肠道不良反应。

综上,一线阿法替尼序贯奥希替尼较吉非替尼或厄洛替尼序贯奥希替尼改善EGFR突变患者的OS。

原始出处:

Kwok WC, Ho JCM, Tam TCC, Ip MSM, Lam DCL. Survival benefits from afatinib compared with gefitinib and erlotinib among patients with common EGFR mutation in first-line setting. Thorac Cancer. 2022 Jun 6. doi: 10.1111/1759-7714.14528. Epub ahead of print. PMID: 35668712.

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    2023-01-13 jklm09
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    2022-06-10 liuyiping

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食道癌作为全球癌症相关死亡的最常见原因之一,放化疗(CRT)同步使用目前被认为是局部晚期食道鳞状细胞癌(ESCC)患者的标准治疗策略。在RTOG 8501临床试验中,相比于单独放疗,5-氟尿嘧啶结合顺

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在临床前研究绿茶多酚E(PPE)与EGFR-酪氨酸激酶抑制剂的协同效应的基础上,Shin等人开展了一项Ib期试验,研究了PPE联合厄洛替尼(EGFR抑制剂)对口腔和喉部晚期癌前病变(APL)的安全性。

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

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。