根据携带表皮生长因子受体突变亚型的转移性非小细胞肺癌患者的突变亚型,奥希替尼一线治疗的进展和疗效存在差异

IF 3 Q2 ONCOLOGY
Yuki Takeyasu MD , Tatsuya Yoshida MD , Ken Masuda MD , Yuji Matsumoto MD , Yuki Shinno MD , Yusuke Okuma MD , Yasushi Goto MD , Hidehito Horinouchi MD , Noboru Yamamoto MD , Yuichiro Ohe MD
{"title":"根据携带表皮生长因子受体突变亚型的转移性非小细胞肺癌患者的突变亚型,奥希替尼一线治疗的进展和疗效存在差异","authors":"Yuki Takeyasu MD ,&nbsp;Tatsuya Yoshida MD ,&nbsp;Ken Masuda MD ,&nbsp;Yuji Matsumoto MD ,&nbsp;Yuki Shinno MD ,&nbsp;Yusuke Okuma MD ,&nbsp;Yasushi Goto MD ,&nbsp;Hidehito Horinouchi MD ,&nbsp;Noboru Yamamoto MD ,&nbsp;Yuichiro Ohe MD","doi":"10.1016/j.jtocrr.2024.100636","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Osimertinib (OSI), a third-generation EGFR tyrosine kinase inhibitor, is the standard treatment for patients with naive EGFR-mutant NSCLC. Nevertheless, information on how the mutation subtype affects disease progression after the failure of OSI treatment is scarce.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed patients with EGFR-mutant NSCLC who received OSI as a first-line treatment between April 2015 and December 2021.</p></div><div><h3>Results</h3><p>This study included 229 patients. The objective response rate was 71%, with intracranial and extracranial response rates of 71% and 90%, respectively. The median progression-free survival was 23.3 mo (95% confidence interval [CI]: 19.6–26.7), and the median overall survival was 33.7 mo (95% CI: 31.3–58.6). Multivariate analysis revealed that the EGFR exon 21 L858R point mutation (L858R) (hazard ratio [HR] = 1.56, 95% CI: 1.04–2.34, <em>p</em> = 0.0328) and liver metastasis (HR = 2.63, 95% CI: 1.53–4.49, <em>p</em> = 0.0004) were significant predictors of progression-free survival in OSI treatment. The concomitant disease progression involving the central nervous system metastasis was significantly more common in patients with L858R (<em>p</em> = 0.048), whereas concomitant disease progression involving primary lesions was significantly more common in patients with exon 19 deletion mutation (<em>p</em> = 0.01). In addition, the probability of disease progression over time was higher for L858R compared with that for exon 19 deletion mutation, in patients with central nervous system metastasis (log-rank test, <em>p</em> = 0.027).</p></div><div><h3>Conclusions</h3><p>The mutation subtype had an impact not only on the clinical outcome of the first-line OSI treatment but also on progression patterns after OSI treatment in patients with NSCLC harboring EGFR mutations.</p></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666364324000067/pdfft?md5=15b5cae6f214b62146bf962b296ac182&pid=1-s2.0-S2666364324000067-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Distinct Progression and Efficacy of First-Line Osimertinib Treatment According to Mutation Subtypes in Metastatic NSCLC Harboring EGFR Mutations\",\"authors\":\"Yuki Takeyasu MD ,&nbsp;Tatsuya Yoshida MD ,&nbsp;Ken Masuda MD ,&nbsp;Yuji Matsumoto MD ,&nbsp;Yuki Shinno MD ,&nbsp;Yusuke Okuma MD ,&nbsp;Yasushi Goto MD ,&nbsp;Hidehito Horinouchi MD ,&nbsp;Noboru Yamamoto MD ,&nbsp;Yuichiro Ohe MD\",\"doi\":\"10.1016/j.jtocrr.2024.100636\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Osimertinib (OSI), a third-generation EGFR tyrosine kinase inhibitor, is the standard treatment for patients with naive EGFR-mutant NSCLC. Nevertheless, information on how the mutation subtype affects disease progression after the failure of OSI treatment is scarce.</p></div><div><h3>Methods</h3><p>We retrospectively reviewed patients with EGFR-mutant NSCLC who received OSI as a first-line treatment between April 2015 and December 2021.</p></div><div><h3>Results</h3><p>This study included 229 patients. The objective response rate was 71%, with intracranial and extracranial response rates of 71% and 90%, respectively. The median progression-free survival was 23.3 mo (95% confidence interval [CI]: 19.6–26.7), and the median overall survival was 33.7 mo (95% CI: 31.3–58.6). Multivariate analysis revealed that the EGFR exon 21 L858R point mutation (L858R) (hazard ratio [HR] = 1.56, 95% CI: 1.04–2.34, <em>p</em> = 0.0328) and liver metastasis (HR = 2.63, 95% CI: 1.53–4.49, <em>p</em> = 0.0004) were significant predictors of progression-free survival in OSI treatment. The concomitant disease progression involving the central nervous system metastasis was significantly more common in patients with L858R (<em>p</em> = 0.048), whereas concomitant disease progression involving primary lesions was significantly more common in patients with exon 19 deletion mutation (<em>p</em> = 0.01). In addition, the probability of disease progression over time was higher for L858R compared with that for exon 19 deletion mutation, in patients with central nervous system metastasis (log-rank test, <em>p</em> = 0.027).</p></div><div><h3>Conclusions</h3><p>The mutation subtype had an impact not only on the clinical outcome of the first-line OSI treatment but also on progression patterns after OSI treatment in patients with NSCLC harboring EGFR mutations.</p></div>\",\"PeriodicalId\":17675,\"journal\":{\"name\":\"JTO Clinical and Research Reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666364324000067/pdfft?md5=15b5cae6f214b62146bf962b296ac182&pid=1-s2.0-S2666364324000067-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JTO Clinical and Research Reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666364324000067\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JTO Clinical and Research Reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666364324000067","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

简介奥西替尼(OSI)是第三代表皮生长因子受体酪氨酸激酶抑制剂,是治疗表皮生长因子受体突变型NSCLC患者的标准疗法。然而,关于突变亚型如何影响OSI治疗失败后的疾病进展的信息却很少。方法我们回顾性研究了2015年4月至2021年12月期间接受OSI一线治疗的EGFR突变NSCLC患者。客观反应率为71%,颅内和颅外反应率分别为71%和90%。中位无进展生存期为23.3个月(95%置信区间[CI]:19.6-26.7),中位总生存期为33.7个月(95%置信区间[CI]:31.3-58.6)。多变量分析显示,表皮生长因子受体外显子21 L858R点突变(L858R)(危险比[HR]=1.56,95% CI:1.04-2.34,p=0.0328)和肝转移(HR=2.63,95% CI:1.53-4.49,p=0.0004)是OSI治疗中无进展生存期的重要预测因素。L858R患者合并中枢神经系统转移的疾病进展明显更常见(p = 0.048),而19外显子缺失突变患者合并原发病灶的疾病进展明显更常见(p = 0.01)。此外,在中枢神经系统转移的患者中,L858R与19号外显子缺失突变相比,随着时间的推移疾病进展的概率更高(对数秩检验,p = 0.027)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Distinct Progression and Efficacy of First-Line Osimertinib Treatment According to Mutation Subtypes in Metastatic NSCLC Harboring EGFR Mutations

Introduction

Osimertinib (OSI), a third-generation EGFR tyrosine kinase inhibitor, is the standard treatment for patients with naive EGFR-mutant NSCLC. Nevertheless, information on how the mutation subtype affects disease progression after the failure of OSI treatment is scarce.

Methods

We retrospectively reviewed patients with EGFR-mutant NSCLC who received OSI as a first-line treatment between April 2015 and December 2021.

Results

This study included 229 patients. The objective response rate was 71%, with intracranial and extracranial response rates of 71% and 90%, respectively. The median progression-free survival was 23.3 mo (95% confidence interval [CI]: 19.6–26.7), and the median overall survival was 33.7 mo (95% CI: 31.3–58.6). Multivariate analysis revealed that the EGFR exon 21 L858R point mutation (L858R) (hazard ratio [HR] = 1.56, 95% CI: 1.04–2.34, p = 0.0328) and liver metastasis (HR = 2.63, 95% CI: 1.53–4.49, p = 0.0004) were significant predictors of progression-free survival in OSI treatment. The concomitant disease progression involving the central nervous system metastasis was significantly more common in patients with L858R (p = 0.048), whereas concomitant disease progression involving primary lesions was significantly more common in patients with exon 19 deletion mutation (p = 0.01). In addition, the probability of disease progression over time was higher for L858R compared with that for exon 19 deletion mutation, in patients with central nervous system metastasis (log-rank test, p = 0.027).

Conclusions

The mutation subtype had an impact not only on the clinical outcome of the first-line OSI treatment but also on progression patterns after OSI treatment in patients with NSCLC harboring EGFR mutations.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
4.20
自引率
0.00%
发文量
145
审稿时长
19 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信