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根据体重指数、体表面积和体重评估吉非替尼对表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌患者的疗效。

Evaluation of gefitinib efficacy according to body mass index, body surface area, and body weight in patients with EGFR-mutated advanced non-small cell lung cancer.

作者信息

Imai Hisao, Kuwako Tomohito, Kaira Kyoichi, Masuda Tomomi, Miura Yosuke, Seki Kaori, Sakurai Reiko, Utsugi Mitsuyoshi, Shimizu Kimihiro, Sunaga Noriaki, Tomizawa Yoshio, Ishihara Shinichi, Ishizuka Takao, Mogi Akira, Hisada Takeshi, Minato Koichi, Takise Atsushi, Saito Ryusei, Yamada Masanobu

机构信息

Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

Department of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashi-nishi, Ohta, Gunma, 373-8550, Japan.

出版信息

Cancer Chemother Pharmacol. 2017 Mar;79(3):497-505. doi: 10.1007/s00280-016-3232-2. Epub 2017 Feb 6.

Abstract

PURPOSE

In patients with epidermal growth factor receptor (EGFR)-mutated, advanced, non-small cell lung cancer (NSCLC), common gefitinib-sensitive EGFR mutations that predict a greater response to therapy include the exon 19 deletion and L858R point mutation. The objective of this study was to evaluate whether body surface area (BSA), body weight (BW), and body mass index (BMI) affect gefitinib efficacy in such patients.

METHODS

The medical charts of 138 consecutive patients with advanced NSCLC harboring sensitive EGFR mutations, who underwent gefitinib treatment, were reviewed. The median BSA and BW were used as cutoff values to evaluate their impact on gefitinib efficacy. BMI was categorized as underweight (<18.5 kg/m), normal (18.5-25 kg/m), and overweight (≥25 kg/m).

RESULTS

The median BSA and BW were 1.48 m and 53 kg, respectively. The overall response rate, progression-free survival (PFS), and overall survival (OS) were 65.2%, 12.2, and 24.2 months, respectively. There were no significant differences in clinical outcomes according to BSA, BW, or BMI alone. Subgroup analysis based on the mutation type and BSA revealed no significant differences in PFS between the groups; however, the median OS in those with exon 19 deletion combined with low BSA was significantly favorable compared with the other groups.

CONCLUSIONS

Gefitinib efficacy in patients with NSCLC harboring sensitive EGFR mutations did not differ according to BSA, BW, and BMI. However, OS was superior in patients with both the exon 19 deletion and low BSA.

摘要

目的

在表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌(NSCLC)患者中,预测对治疗反应更大的常见吉非替尼敏感EGFR突变包括外显子19缺失和L858R点突变。本研究的目的是评估体表面积(BSA)、体重(BW)和体重指数(BMI)是否会影响此类患者的吉非替尼疗效。

方法

回顾了138例接受吉非替尼治疗的连续晚期NSCLC患者的病历,这些患者携带敏感的EGFR突变。以BSA和BW的中位数作为临界值来评估它们对吉非替尼疗效的影响。BMI分为体重过低(<18.5kg/m)、正常(18.5 - 25kg/m)和超重(≥25kg/m)。

结果

BSA和BW的中位数分别为1.48m和53kg。总缓解率、无进展生存期(PFS)和总生存期(OS)分别为65.2%、12.2个月和24.2个月。单独根据BSA、BW或BMI,临床结局无显著差异。基于突变类型和BSA的亚组分析显示,各组之间的PFS无显著差异;然而,外显子19缺失合并低BSA患者的中位OS明显优于其他组。

结论

携带敏感EGFR突变的NSCLC患者中,吉非替尼疗效不受BSA、BW和BMI的影响。然而,外显子19缺失且BSA较低的患者OS更佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b498/5344961/0dd5ebe4493a/280_2016_3232_Fig1_HTML.jpg

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