Department of Thoracic Diseases, Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
J Thorac Oncol. 2010 Jul;5(7):1042-7. doi: 10.1097/JTO.0b013e3181da36db.
This post hoc analysis investigated the relationship between tumor response and overall survival (OS) in pretreated advanced non-small cell lung cancer (NSCLC).
We conducted landmark survival analyses of V-15-32, a phase III study comparing gefitinib with docetaxel in pretreated advanced NSCLC. Best response at weeks 8, 12, 16, and 20, and visit response at week 4, were evaluated.
Disease control (DC; complete response [CR], partial response [PR], or stable disease) was a better predictor of OS than CR/PR at all time points. The strongest predictor of OS for both gefitinib and docetaxel was DC at week 8 (hazard ratio [HR] DC versus non-DC: 0.30, 95% confidence interval [CI] 0.20-0.45, p < 0.001 for both treatments). DC at week 4 was also associated with longer survival compared with non-DC for both treatments (HR 0.33, 95% CI 0.23-0.49, p < 0.001 for gefitinib; HR 0.30, 95% CI 0.19-0.47, p < 0.001 for docetaxel).
DC is a better predictor of OS with gefitinib and docetaxel than CR/PR in advanced pretreated NSCLC, with a best response of DC at week 8 the strongest predictor.
本回顾性分析旨在探讨预处理的晚期非小细胞肺癌(NSCLC)患者的肿瘤缓解与总生存期(OS)之间的关系。
我们对 V-15-32 进行了生存里程碑分析,这是一项 III 期研究,比较了吉非替尼与多西他赛在预处理的晚期 NSCLC 中的疗效。评估了第 8、12、16 和 20 周的最佳缓解以及第 4 周的访视缓解情况。
疾病控制(DC;完全缓解[CR]、部分缓解[PR]或稳定疾病)比所有时间点的 CR/PR 更能预测 OS。对于吉非替尼和多西他赛,8 周时的 DC 是 OS 的最强预测因素(DC 与非-DC 的 HR:0.30,95%CI 0.20-0.45,p<0.001,两种治疗方法均如此)。与非-DC 相比,4 周时的 DC 也与两种治疗方法的生存时间延长相关(HR 0.33,95%CI 0.23-0.49,p<0.001,吉非替尼;HR 0.30,95%CI 0.19-0.47,p<0.001,多西他赛)。
与 CR/PR 相比,DC 是预测吉非替尼和多西他赛治疗晚期预处理 NSCLC 患者 OS 的更好指标,8 周时的 DC 最佳缓解是最强的预测因素。