Wenli Cao, Furong Kou, Weiheng Hu, Li Hu, Jun Nie, Ling Dai, Jie Zhang, Jinqiu Rui, Magdalena Knetki-Wróblewska, Mara B Antonoff, Jian Fang, Yang Wang
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引用次数: 0
Abstract
Background: Immunotherapy has become the standard therapy for advanced non-small cell lung cancer (NSCLC), but its efficacy in patients with rare mutations remains unclear. This study aimed to evaluate the efficacy of first-line immunotherapy in NSCLC patients with rare mutations.
Methods: This study selected 2,107 advanced non-squamous NSCLC patients who underwent genetic testing between January 2016 and April 2024 at Peking University Cancer Hospital. Inclusion criteria were patients with rare mutations (including HER2, MET, BRAF, MET, and NTRK) who received first-line immunotherapy or targeted therapy. Mutation-negative patients receiving first-line immunotherapy were also included as a control group. The log-rank test was used to compare progression-free survival (PFS) and overall survival (OS) between different groups.
Results: A total of 66 patients with rare mutations and 142 patients with negative mutations were included. Among them, 39 rare mutation patients and 142 mutation-negative patients received first-line immunotherapy, while 27 rare mutation patients received first-line targeted therapy. For patients receiving first-line immunotherapy, there was no significant difference between the rare mutation group and the mutation-negative group in median PFS (14.53 vs. 12.43 months, P=0.93) and median OS (34.40 vs. 32.37 months, P=0.51). Among rare mutation patients, median OS was superior with first-line immunotherapy compared to targeted therapy (34.40 vs. 16.37 months, P=0.008), but median PFS showed no difference (14.53 vs. 7.03 months, P=0.10).
Conclusions: Advanced non-squamous NSCLC patients with rare mutations may benefit from first-line immunotherapy.
背景：免疫治疗已成为晚期非小细胞肺癌（NSCLC）的标准治疗方法，但其对罕见突变患者的疗效尚不清楚。本研究旨在评估一线免疫治疗对罕见突变NSCLC患者的疗效。方法：本研究选择2016年1月至2024年4月在北京大学肿瘤医院行基因检测的2107例晚期非鳞状NSCLC患者。纳入标准是接受一线免疫治疗或靶向治疗的罕见突变（包括HER2、MET、BRAF、MET和NTRK）患者。接受一线免疫治疗的突变阴性患者也作为对照组。采用log-rank检验比较不同组间的无进展生存期（PFS）和总生存期（OS）。结果：共纳入66例罕见突变患者和142例阴性突变患者。其中39例罕见突变患者和142例突变阴性患者接受了一线免疫治疗，27例罕见突变患者接受了一线靶向治疗。在接受一线免疫治疗的患者中，罕见突变组和突变阴性组的中位PFS （14.53 vs 12.43个月，P=0.93）和中位OS （34.40 vs 32.37个月，P=0.51）差异无统计学意义。在罕见突变患者中，一线免疫治疗的中位OS优于靶向治疗（34.40 vs. 16.37个月，P=0.008），但中位PFS无差异（14.53 vs. 7.03个月，P=0.10）。结论：罕见突变的晚期非鳞状NSCLC患者可能受益于一线免疫治疗。
期刊介绍：
Translational Lung Cancer Research(TLCR, Transl Lung Cancer Res, Print ISSN 2218-6751; Online ISSN 2226-4477) is an international, peer-reviewed, open-access journal, which was founded in March 2012. TLCR is indexed by PubMed/PubMed Central and the Chemical Abstracts Service (CAS) Databases. It is published quarterly the first year, and published bimonthly since February 2013. It provides practical up-to-date information on prevention, early detection, diagnosis, and treatment of lung cancer. Specific areas of its interest include, but not limited to, multimodality therapy, markers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to lung cancer.
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