Bo Yan , Bo Zhang , Tianqing Chu , Wei Zhang , Chunlei Shi , Huimin Wang , Xueyan Zhang , Baohui Han , Hua Zhong
{"title":"奥西替尼联合安洛替尼作为EGFR突变晚期或转移性NSCLC患者的一线治疗:一项前瞻性单组探索性研究","authors":"Bo Yan , Bo Zhang , Tianqing Chu , Wei Zhang , Chunlei Shi , Huimin Wang , Xueyan Zhang , Baohui Han , Hua Zhong","doi":"10.1016/j.lungcan.2025.108627","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Osimertinib plus chemotherapy significantly improved PFS as first-line (1L) treatment in EFGR mutated (EGFRm) advanced NSCLC (FLAURA2). To mitigate the cytotoxicity and inconvenience of chemotherapy, we explored a chemo-free oral combination therapy with osimertinib (osi) plus anlotinib (anlo, a multi-targeted TKI inhibit both tumor angiogenesis and growth) in 1L setting.</div></div><div><h3>Methods</h3><div>This is a prospective, single arm, exploratory study. Treatment-naïve patients (pts) with EGFRm advanced NSCLC were enrolled. The part A assessed the recommended dose of the combination of osimertinib plus anlotinib for further clinical evaluation based upon assessment of the safety and tolerability data (Part A: osi, 80mg daily; anlo, 8mg/10mg/12mg daily, D1-14, 21d/cycle). Part B was an expansion cohort. Primary endpoint was recommended phase 2 dose (RP2D) (Part A) and objective response rate (ORR) (Part B).</div></div><div><h3>Results</h3><div>25 eligible patients were enrolled. The RP2D is osimertinib 80mg, once daily and anlotinib (12 mg/day orally, 14 days on and 7 days off). Adverse events of any cause (TEAE) and any grade was observed in 24 (96.0%) patients. 8 (32.0%) patients experienced grade 3 TEAE. Serious adverse events were reported in 4 (16.0%) patients. In FAS population (defined as patients who received at least one dose of study drugs), ORR and DCR was 60.0% (15/25 patients, 95% CI, 38.7%-78.9%) and 88.0% (22/25 patients, 95% CI, 68.8%-97.5%), respectively. Median PFS and OS were 31.5 months (95%CI, 17.9 months-NE) and not reached, respectively, with 36 months PFS and OS rate were 31.9% (95%CI, 17.3%-58.8%) and 74.3% (95% CI, 58.5%-94.4%), respectively.</div></div><div><h3>Conclusions</h3><div>Osimertinib combined with full dose anlotinib showed manageable safety profile and encouraging efficacy, deserving further investigation.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108627"},"PeriodicalIF":4.5000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Osimertinib combined with anlotinib as first-line treatment in advanced or metastatic NSCLC patients with EGFR mutation: a prospective, single arm, exploratory study\",\"authors\":\"Bo Yan , Bo Zhang , Tianqing Chu , Wei Zhang , Chunlei Shi , Huimin Wang , Xueyan Zhang , Baohui Han , Hua Zhong\",\"doi\":\"10.1016/j.lungcan.2025.108627\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Osimertinib plus chemotherapy significantly improved PFS as first-line (1L) treatment in EFGR mutated (EGFRm) advanced NSCLC (FLAURA2). To mitigate the cytotoxicity and inconvenience of chemotherapy, we explored a chemo-free oral combination therapy with osimertinib (osi) plus anlotinib (anlo, a multi-targeted TKI inhibit both tumor angiogenesis and growth) in 1L setting.</div></div><div><h3>Methods</h3><div>This is a prospective, single arm, exploratory study. Treatment-naïve patients (pts) with EGFRm advanced NSCLC were enrolled. The part A assessed the recommended dose of the combination of osimertinib plus anlotinib for further clinical evaluation based upon assessment of the safety and tolerability data (Part A: osi, 80mg daily; anlo, 8mg/10mg/12mg daily, D1-14, 21d/cycle). Part B was an expansion cohort. Primary endpoint was recommended phase 2 dose (RP2D) (Part A) and objective response rate (ORR) (Part B).</div></div><div><h3>Results</h3><div>25 eligible patients were enrolled. The RP2D is osimertinib 80mg, once daily and anlotinib (12 mg/day orally, 14 days on and 7 days off). Adverse events of any cause (TEAE) and any grade was observed in 24 (96.0%) patients. 8 (32.0%) patients experienced grade 3 TEAE. Serious adverse events were reported in 4 (16.0%) patients. In FAS population (defined as patients who received at least one dose of study drugs), ORR and DCR was 60.0% (15/25 patients, 95% CI, 38.7%-78.9%) and 88.0% (22/25 patients, 95% CI, 68.8%-97.5%), respectively. Median PFS and OS were 31.5 months (95%CI, 17.9 months-NE) and not reached, respectively, with 36 months PFS and OS rate were 31.9% (95%CI, 17.3%-58.8%) and 74.3% (95% CI, 58.5%-94.4%), respectively.</div></div><div><h3>Conclusions</h3><div>Osimertinib combined with full dose anlotinib showed manageable safety profile and encouraging efficacy, deserving further investigation.</div></div>\",\"PeriodicalId\":18129,\"journal\":{\"name\":\"Lung Cancer\",\"volume\":\"205 \",\"pages\":\"Article 108627\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-06-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lung Cancer\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0169500225005197\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lung Cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0169500225005197","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Osimertinib combined with anlotinib as first-line treatment in advanced or metastatic NSCLC patients with EGFR mutation: a prospective, single arm, exploratory study
Introduction
Osimertinib plus chemotherapy significantly improved PFS as first-line (1L) treatment in EFGR mutated (EGFRm) advanced NSCLC (FLAURA2). To mitigate the cytotoxicity and inconvenience of chemotherapy, we explored a chemo-free oral combination therapy with osimertinib (osi) plus anlotinib (anlo, a multi-targeted TKI inhibit both tumor angiogenesis and growth) in 1L setting.
Methods
This is a prospective, single arm, exploratory study. Treatment-naïve patients (pts) with EGFRm advanced NSCLC were enrolled. The part A assessed the recommended dose of the combination of osimertinib plus anlotinib for further clinical evaluation based upon assessment of the safety and tolerability data (Part A: osi, 80mg daily; anlo, 8mg/10mg/12mg daily, D1-14, 21d/cycle). Part B was an expansion cohort. Primary endpoint was recommended phase 2 dose (RP2D) (Part A) and objective response rate (ORR) (Part B).
Results
25 eligible patients were enrolled. The RP2D is osimertinib 80mg, once daily and anlotinib (12 mg/day orally, 14 days on and 7 days off). Adverse events of any cause (TEAE) and any grade was observed in 24 (96.0%) patients. 8 (32.0%) patients experienced grade 3 TEAE. Serious adverse events were reported in 4 (16.0%) patients. In FAS population (defined as patients who received at least one dose of study drugs), ORR and DCR was 60.0% (15/25 patients, 95% CI, 38.7%-78.9%) and 88.0% (22/25 patients, 95% CI, 68.8%-97.5%), respectively. Median PFS and OS were 31.5 months (95%CI, 17.9 months-NE) and not reached, respectively, with 36 months PFS and OS rate were 31.9% (95%CI, 17.3%-58.8%) and 74.3% (95% CI, 58.5%-94.4%), respectively.
Conclusions
Osimertinib combined with full dose anlotinib showed manageable safety profile and encouraging efficacy, deserving further investigation.
期刊介绍:
Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.