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JCO：Osimertinib比化疗有利于改善晚期非小细胞肺癌患者的状态

2018-05-12 MedSci MedSci原创

非小细胞肺癌osimertinib化疗
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在评估新的肿瘤治疗策略的总临床获益时，患者报告的结局数据很重要。JCO近期发表了一篇文章，评估接受Osimertinib或化疗治疗的晚期非小细胞肺癌患者报告的症状区别。

在评估新的肿瘤治疗策略的总临床获益时，患者报告的结局数据很重要。JCO近期发表了一篇文章，评估接受Osimertinib或化疗治疗的晚期非小细胞肺癌患者报告的症状区别。

患者完成针对疾病特异性症状的EORTC QLQ-LC13问卷以及针对一般肿瘤症状，功能，整体健康状态以及生活质量的EORTC QLC-C30问卷。作者评估了两种治疗方式个体症状出现恶化的时间间隔以及改善比例的区别。基线时，82%-88%的患者完成问卷，30%-70%的患者有个体症状。Osimertinib组与化疗组相比，咳嗽，胸痛以及呼吸困难等症状出现恶化的时间间隔更长。Osimertinib组与化疗组相比，有症状的患者整体健康状态和生活质量改善的比例更高。食欲降低以及虚弱的患者比例也更高。

文章最后认为，Osimertinib组与化疗组相比，主要症状出现恶化的时间间隔更长，患者整体健康状态和生活质量改善的比例更高，说明Osimertinib可以改善患者结局。

原始出处：

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    2018-09-23 lingaifan

    #非小细胞#

    0

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    2019-03-04 gds2009

    #肺癌患者#

    0

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    2018-06-28 lidong40

    #JCO#

    0

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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-17 hanmeijinxiu

    学习了.谢谢分享.

    0

  5. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-16 121832a9m88暂无昵称

    学习了

    0

  6. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-14 dongjia2012

    #osimertinib#

    0

  7. 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likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat May 12 23:13:12 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314533, encodeId=067131453351, content=不错的文章值得拥有, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sat May 12 22:35:06 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314522, encodeId=443b31452296, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-14 zxxiang

    #非小细胞肺癌患者#

    0

  8. 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topicList=[TopicDto(id=13501, encryptionId=4f2113501a7, topicName=osimertinib)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=126d6614911, createdName=dongjia2012, createdTime=Mon May 14 11:15:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600835, encodeId=55ed16008352a, content=<a href='/topic/show?id=973e99390a4' target=_blank style='color:#2F92EE;'>#非小细胞肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99390, encryptionId=973e99390a4, topicName=非小细胞肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e0218815946, createdName=zxxiang, createdTime=Mon May 14 11:15:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314543, encodeId=08aa314543a8, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat May 12 23:13:12 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314533, encodeId=067131453351, content=不错的文章值得拥有, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sat May 12 22:35:06 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314522, encodeId=443b31452296, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-12 神功盖世

    阅

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2059708, encodeId=f2e02059e08bd, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sun Sep 23 09:15:00 CST 2018, time=2018-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1990639, encodeId=f4f7199063903, content=<a href='/topic/show?id=5739822223f' target=_blank style='color:#2F92EE;'>#肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82222, encryptionId=5739822223f, topicName=肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIxvMP6OXzUiaGH5MkDQlW0hczROZxec1gZjfZ52EtN6aG9t0uDZq2A5xmf9FWMa4tZib4qoYnledFg/132, createdBy=9d6c2167401, createdName=hanmeijinxiu, createdTime=Thu May 17 10:50:06 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315508, encodeId=037331550800, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Wed May 16 05:39:46 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464198, encodeId=34f31464198a6, content=<a href='/topic/show?id=4f2113501a7' target=_blank style='color:#2F92EE;'>#osimertinib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13501, encryptionId=4f2113501a7, topicName=osimertinib)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=126d6614911, createdName=dongjia2012, createdTime=Mon May 14 11:15:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600835, encodeId=55ed16008352a, content=<a href='/topic/show?id=973e99390a4' target=_blank style='color:#2F92EE;'>#非小细胞肺癌患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99390, encryptionId=973e99390a4, topicName=非小细胞肺癌患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2e0218815946, createdName=zxxiang, createdTime=Mon May 14 11:15:00 CST 2018, time=2018-05-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314543, encodeId=08aa314543a8, content=阅, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat May 12 23:13:12 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314533, encodeId=067131453351, content=不错的文章值得拥有, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sat May 12 22:35:06 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314522, encodeId=443b31452296, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-12 1e1b8538m79(暂无匿称)

    不错的文章值得拥有

    0

  10. 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createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIxvMP6OXzUiaGH5MkDQlW0hczROZxec1gZjfZ52EtN6aG9t0uDZq2A5xmf9FWMa4tZib4qoYnledFg/132, createdBy=9d6c2167401, createdName=hanmeijinxiu, createdTime=Thu May 17 10:50:06 CST 2018, time=2018-05-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=315508, encodeId=037331550800, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Wed May 16 05:39:46 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1464198, encodeId=34f31464198a6, content=<a href='/topic/show?id=4f2113501a7' target=_blank style='color:#2F92EE;'>#osimertinib#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, 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likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/fhZdOu27e88Voqh19n8eF8cLplo8L4nicKtH0WnE3KFELXns5XDu8rsiceK2HHDZc2SEStia5VV3Pia2QLMVqlWbHw/0, createdBy=6e012139475, createdName=神功盖世, createdTime=Sat May 12 23:13:12 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314533, encodeId=067131453351, content=不错的文章值得拥有, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Sat May 12 22:35:06 CST 2018, time=2018-05-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=314522, encodeId=443b31452296, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat May 12 22:12:59 CST 2018, time=2018-05-12, status=1, ipAttribution=)]
    2018-05-12 清风拂面

    谢谢分享学习

    0

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该文对 2018 年 V3 版《NCCN 非小细胞肺癌诊治指南》进行解读。与 2017 年 V9 版《NCCN 非小细胞肺癌诊治指南》相比，新版指南基于最新的循证医学证据，以分子分型和靶向治疗进展为主，规范了病理评估原则、分子检测方法、靶向耐药后续治疗，以及驱动基因阳性患者的免疫治疗选择等，并更新了分期系统，有助于更高效、更精准地指导临床实践。

NCCN临床实践指南：非小细胞肺癌（2018.V4）

2018年4月，美国国家综合癌症网络(NCCN)发布了非小细胞肺癌指南2018年第4版，指南主要内容涉及： 指南更新摘要 肺癌的预防和筛查 肺癌的临床表现和风险评估 初始评估和临床分期 各期肺癌的评估和治疗 完成确定治疗后监测 复发和转移性疾病的治疗 转移性疾病的系统治疗 病理检查原则 手术治疗原则 放射治疗原则 新辅助化疗方案与辅助治疗 放射治疗和化疗 晚期或转移性疾病的系统治疗 幸存者照护 基

PLos One：miR-133b高表达与非小细胞肺癌中使用厄洛替尼作为二三线治疗的疗效较好相关

肿瘤中miR-133b表达水平检测有助于识别预后较好并可能从使用厄洛替尼作为二三线治疗中受益的NSCLC患者。

CLIN CANCER RES：VISTA/PD-1H可作为非小细胞肺癌免疫治疗靶点

VISTA/PD-1H参与免疫调节，临床试验正在评估VISTA阻滞的抗肿瘤效果。但是，人恶性肿瘤VISTA表达的生物学影响尚缺乏进一步研究。CLIN CANCER RES近期发表了一篇文章，研究VISTA/PD-1H在非小细胞肺癌中的临床意义。

PD-L1/ CTLA-4免疫联合治疗非小细胞肺癌未能获益

Top-line数据显示与SoC相比，Imfinzi/tremelimumab联合治疗未能显示出无进展生存期（PFS）和总生存期（OS）的统计学显著的改善。但阿斯利康表示Imfinzi单药治疗与化疗相比确实显示出具有临床意义的死亡风险降低。

ROS1阳性非小细胞肺癌诊断病理专家共识

准确的分子靶标检测是NSCLC患者获取靶向治疗的前提。与ALK融合基因检测类似，目前针对ROS1融合基因的常用方法有3种：FISH、RT－PCR和免疫组织化学法。上述3种方法各有其优缺点。FISH方法为美国国家综合癌症网络(NCCN)指南推荐的检测ROS1融合基因的检测方法，但价格昂贵，操作规范要求较高，目前还没有一家公司的FISH获得FDA的批准；RT－PCR对标本质量要求较高，需专用的试剂盒进