贝伐珠单抗或雷莫芦单抗联合表皮生长因子受体(EGFR)酪氨酸激酶抑制剂作为易受 EGFR 突变影响的晚期非小细胞肺癌一线疗法的临床疗效。

The Kaohsiung journal of medical sciences Pub Date : 2024-05-01 Epub Date: 2024-03-25 DOI:10.1002/kjm2.12822
Chia-Yu Kuo, Ming-Ju Tsai, Jen-Yu Hung, Mei-Hsuan Lee, Kuan-Li Wu, Yu-Chen Tsai, Cheng-Hao Chuang, Chung-Wen Huang, Chin-Ling Chen, Chih-Jen Yang, Inn-Wen Chong
{"title":"贝伐珠单抗或雷莫芦单抗联合表皮生长因子受体(EGFR)酪氨酸激酶抑制剂作为易受 EGFR 突变影响的晚期非小细胞肺癌一线疗法的临床疗效。","authors":"Chia-Yu Kuo, Ming-Ju Tsai, Jen-Yu Hung, Mei-Hsuan Lee, Kuan-Li Wu, Yu-Chen Tsai, Cheng-Hao Chuang, Chung-Wen Huang, Chin-Ling Chen, Chih-Jen Yang, Inn-Wen Chong","doi":"10.1002/kjm2.12822","DOIUrl":null,"url":null,"abstract":"<p><p>Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with an anti- vascular endothelial growth factor (VEGF) agent, bevacizumab or ramucirumab, is indicated for advanced lung adenocarcinoma harboring EGFR mutation. This study aimed to show the real-world data of combination therapy and compare the effectiveness between bevacizumab and ramucirumab in combination with an EGFR-TKI. This retrospective study enrolled 47 patients diagnosed of stage IV lung adenocarcinoma with exon 19 deletion or L858R point mutation, receiving a first-line EGFR-TKI with anti-VEGF agent, including 34 (72%) and 13 (28%) patients receiving bevacizumab and ramucirumab, respectively. The response rate was similar in both groups (p = 0.38). Patients receiving bevacizumab had similar progression free survival (PFS) as those receiving ramucirumab (median PFS: 21.9 vs. 24.2 months, p = 0.4871); similar finding was noted in overall survival (OS) (median OS: 33.5 months vs. not reached, p = 0.4618). Patients receiving ramucirumab experienced a significantly high-grade hypertension compared to those receiving bevacizumab (p = 0.0351). Multivariable Cox regression analysis found independent risk factors for worse PFS included poorer ECOG performance status, multiple (≥3) metastatic sites, brain metastasis, and pleural metastasis/effusion, while the type of anti-VEGF agent was not a risk factor. Pericardial metastasis/effusion was the only one independent risk factor for worse OS. In summary, ramucirumab may have similar effectiveness as bevacizumab in combination with an EGFR-TKI as first line therapy for advanced lung adenocarcinoma harboring susceptible EGFR mutation. Further large-scale registry-based cohort studies may be needed to validate our findings.</p>","PeriodicalId":94244,"journal":{"name":"The Kaohsiung journal of medical sciences","volume":" ","pages":"467-476"},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical outcome of bevacizumab or ramucirumab combined with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as the first line therapy in susceptible EGFR-mutated advanced non-small-cell lung.\",\"authors\":\"Chia-Yu Kuo, Ming-Ju Tsai, Jen-Yu Hung, Mei-Hsuan Lee, Kuan-Li Wu, Yu-Chen Tsai, Cheng-Hao Chuang, Chung-Wen Huang, Chin-Ling Chen, Chih-Jen Yang, Inn-Wen Chong\",\"doi\":\"10.1002/kjm2.12822\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with an anti- vascular endothelial growth factor (VEGF) agent, bevacizumab or ramucirumab, is indicated for advanced lung adenocarcinoma harboring EGFR mutation. This study aimed to show the real-world data of combination therapy and compare the effectiveness between bevacizumab and ramucirumab in combination with an EGFR-TKI. This retrospective study enrolled 47 patients diagnosed of stage IV lung adenocarcinoma with exon 19 deletion or L858R point mutation, receiving a first-line EGFR-TKI with anti-VEGF agent, including 34 (72%) and 13 (28%) patients receiving bevacizumab and ramucirumab, respectively. The response rate was similar in both groups (p = 0.38). Patients receiving bevacizumab had similar progression free survival (PFS) as those receiving ramucirumab (median PFS: 21.9 vs. 24.2 months, p = 0.4871); similar finding was noted in overall survival (OS) (median OS: 33.5 months vs. not reached, p = 0.4618). Patients receiving ramucirumab experienced a significantly high-grade hypertension compared to those receiving bevacizumab (p = 0.0351). Multivariable Cox regression analysis found independent risk factors for worse PFS included poorer ECOG performance status, multiple (≥3) metastatic sites, brain metastasis, and pleural metastasis/effusion, while the type of anti-VEGF agent was not a risk factor. Pericardial metastasis/effusion was the only one independent risk factor for worse OS. In summary, ramucirumab may have similar effectiveness as bevacizumab in combination with an EGFR-TKI as first line therapy for advanced lung adenocarcinoma harboring susceptible EGFR mutation. Further large-scale registry-based cohort studies may be needed to validate our findings.</p>\",\"PeriodicalId\":94244,\"journal\":{\"name\":\"The Kaohsiung journal of medical sciences\",\"volume\":\" \",\"pages\":\"467-476\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Kaohsiung journal of medical sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/kjm2.12822\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/3/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Kaohsiung journal of medical sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/kjm2.12822","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/3/25 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)与抗血管内皮生长因子(VEGF)药物贝伐珠单抗(bevacizumab)或雷木单抗(ramucirumab)联合治疗表皮生长因子受体(EGFR)突变的晚期肺腺癌。本研究旨在展示联合治疗的实际数据,并比较贝伐单抗和雷莫芦单抗与 EGFR-TKI 联合治疗的疗效。这项回顾性研究共纳入了47例确诊为外显子19缺失或L858R点突变的IV期肺腺癌患者,他们均接受了一线EGFR-TKI联合抗血管内皮生长因子药物治疗,其中34例(72%)和13例(28%)患者分别接受了贝伐单抗和雷莫芦单抗治疗。两组患者的应答率相似(P = 0.38)。接受贝伐珠单抗治疗的患者与接受拉莫单抗治疗的患者的无进展生存期(PFS)相似(中位PFS:21.9个月 vs. 24.2个月,p = 0.4871);总生存期(OS)也相似(中位OS:33.5个月 vs. 未达到,p = 0.4618)。与接受贝伐珠单抗治疗的患者相比,接受雷莫芦单抗治疗的患者出现明显的高血压(p = 0.0351)。多变量考克斯回归分析发现,PFS较差的独立风险因素包括较差的ECOG表现状态、多个(≥3个)转移部位、脑转移和胸膜转移/渗出,而抗VEGF药物的类型不是风险因素。心包转移/浸润是唯一一个导致OS恶化的独立危险因素。总之,ramucirumab与贝伐珠单抗联合EGFR-TKI作为携带易感EGFR突变的晚期肺腺癌的一线疗法,可能具有与贝伐珠单抗相似的疗效。要验证我们的研究结果,可能还需要进一步开展基于登记的大规模队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical outcome of bevacizumab or ramucirumab combined with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as the first line therapy in susceptible EGFR-mutated advanced non-small-cell lung.

Combining epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) with an anti- vascular endothelial growth factor (VEGF) agent, bevacizumab or ramucirumab, is indicated for advanced lung adenocarcinoma harboring EGFR mutation. This study aimed to show the real-world data of combination therapy and compare the effectiveness between bevacizumab and ramucirumab in combination with an EGFR-TKI. This retrospective study enrolled 47 patients diagnosed of stage IV lung adenocarcinoma with exon 19 deletion or L858R point mutation, receiving a first-line EGFR-TKI with anti-VEGF agent, including 34 (72%) and 13 (28%) patients receiving bevacizumab and ramucirumab, respectively. The response rate was similar in both groups (p = 0.38). Patients receiving bevacizumab had similar progression free survival (PFS) as those receiving ramucirumab (median PFS: 21.9 vs. 24.2 months, p = 0.4871); similar finding was noted in overall survival (OS) (median OS: 33.5 months vs. not reached, p = 0.4618). Patients receiving ramucirumab experienced a significantly high-grade hypertension compared to those receiving bevacizumab (p = 0.0351). Multivariable Cox regression analysis found independent risk factors for worse PFS included poorer ECOG performance status, multiple (≥3) metastatic sites, brain metastasis, and pleural metastasis/effusion, while the type of anti-VEGF agent was not a risk factor. Pericardial metastasis/effusion was the only one independent risk factor for worse OS. In summary, ramucirumab may have similar effectiveness as bevacizumab in combination with an EGFR-TKI as first line therapy for advanced lung adenocarcinoma harboring susceptible EGFR mutation. Further large-scale registry-based cohort studies may be needed to validate our findings.

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
自引率
0.00%
发文量
0
×
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