影响含或不含贝伐珠单抗的 S-1 治疗后既往治疗的晚期非小细胞肺癌患者无进展生存期的临床病理因素。
Clinicopathological factors affecting progression-free survival of patients with previously treated advanced non-small cell lung cancer after S-1 therapy with or without bevacizumab.
机构信息
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan
Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
出版信息
Anticancer Res. 2014 Dec;34(12):7467-72.
OBJECTIVES
The aim of the present study was to analyze factors that affect progression-free survival (PFS) of patients with previously treated advanced non-small cell lung cancer (NSCLC) after S-1 therapy, in particular epidermal growth factor receptor (EGFR) mutation status.
PATIENTS AND METHODS
Between October 2009 and June 2013, 56 patients with advanced NSCLC were analyzed for EGFR somatic mutations and treated with S-1 with or without bevacizumab. Risk factors associated with PFS were evaluated using a Cox proportional hazards regression model with a step-down procedure. Proportional hazards assumptions were checked and satisfied and only variables with statistical significance in univariate analysis were included in multivariate analysis.
RESULTS
The median PFS of patients with EGFR mutations who received S-1 therapy was significantly longer than that of patients with wild-type EGFR. The median PFS of patients with good performance status (PS) was significantly longer than that of patients with poor PS. In multivariate analysis, wild-type EGFR and poor PS were significant and independent negative factors that affect PFS after S-1 therapy.
CONCLUSION
EGFR mutation and good PS were positive predictive factors for PFS after S-1 therapy, suggesting that S-1 therapy is efficacious for patients with EGFR-activating mutations even in a multi-line setting.
目的
本研究旨在分析 S-1 治疗后先前治疗的晚期非小细胞肺癌（NSCLC）患者无进展生存期（PFS）的影响因素，特别是表皮生长因子受体（EGFR）突变状态。
方法
2009 年 10 月至 2013 年 6 月，对 56 例晚期 NSCLC 患者进行 EGFR 体细胞突变分析，并接受 S-1 联合或不联合贝伐单抗治疗。使用逐步降序 Cox 比例风险回归模型评估与 PFS 相关的风险因素。检查并满足比例风险假设，仅将单因素分析中有统计学意义的变量纳入多因素分析。
结果
接受 S-1 治疗的 EGFR 突变患者的中位 PFS 明显长于野生型 EGFR 患者。表现状态（PS）良好的患者的中位 PFS 明显长于 PS 差的患者。多因素分析中，野生型 EGFR 和 PS 差是影响 S-1 治疗后 PFS 的显著和独立的负性因素。
结论
EGFR 突变和良好的 PS 是 S-1 治疗后 PFS 的阳性预测因素，表明 S-1 治疗对 EGFR 激活突变患者有效，即使在多线治疗环境中也是如此。
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