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苹果试验:AZD9291(奥希替尼)治疗表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)患者血浆T790M阳性的可行性和活性。欧洲癌症研究与治疗组织(EORTC)1613号试验

The APPLE Trial: Feasibility and Activity of AZD9291 (Osimertinib) Treatment on Positive PLasma T790M in EGFR-mutant NSCLC Patients. EORTC 1613.

作者信息

Remon Jordi, Menis Jessica, Hasan Baktiar, Peric Aleksandra, De Maio Eleonora, Novello Silvia, Reck Martin, Berghmans Thierry, Wasag Bartosz, Besse Benjamin, Dziadziuszko Rafal

机构信息

Department of Oncology Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France.

European Organisation for Research and Treatment of Cancer, Brussels, Belgium.

出版信息

Clin Lung Cancer. 2017 Sep;18(5):583-588. doi: 10.1016/j.cllc.2017.02.005. Epub 2017 Mar 1.


DOI:10.1016/j.cllc.2017.02.005
PMID:28341106
Abstract

The AZD9291 (Osimertinib) Treatment on Positive PLasma T790M in EGFR-mutant NSCLC Patients (APPLE) trial is a randomized, open-label, multicenter, 3-arm, phase II study in advanced, epidermal growth factor receptor (EGFR)-mutant and EGFR tyrosine kinase inhibitor (TKI)-naive non-small-cell lung cancer (NSCLC) patients, to evaluate the best strategy for sequencing gefitinib and osimertinib treatment. Advanced EGFR-mutant NSCLC patients, with World Health Organization performance status 0-2 who are EGFR TKI treatment-naive and eligible to receive first-line treatment with EGFR TKI will be randomized to: In all arms, a plasmatic ctDNA T790M test will be performed by a central laboratory at the Medical University of Gdansk (Poland) but will be applied as a predictive marker for making treatment decisions only in arm B. The primary objective is to evaluate the best strategy for sequencing of treatment with gefitinib and osimertinib in advanced NSCLC patients with common EGFR mutations, and to understand the value of liquid biopsy for the decision-making process. The progression-free survival rate at 18 months is the primary end point of the trial. The activity of osimertinib versus gefitinib to prevent brain metastases will be evaluated.

摘要

AZD9291(奥希替尼)治疗EGFR突变的非小细胞肺癌患者血浆T790M阳性(APPLE)试验是一项针对晚期、表皮生长因子受体(EGFR)突变且未接受过EGFR酪氨酸激酶抑制剂(TKI)治疗的非小细胞肺癌(NSCLC)患者的随机、开放标签、多中心、三臂II期研究,旨在评估吉非替尼和奥希替尼序贯治疗的最佳策略。符合条件的晚期EGFR突变NSCLC患者,世界卫生组织体能状态为0 - 2,未接受过EGFR TKI治疗且有资格接受EGFR TKI一线治疗,将被随机分组:在所有组中,血浆循环肿瘤DNA(ctDNA)T790M检测将由波兰格但斯克医科大学的中央实验室进行,但仅在B组用作治疗决策的预测标志物。主要目的是评估晚期常见EGFR突变NSCLC患者中吉非替尼和奥希替尼序贯治疗的最佳策略,并了解液体活检在决策过程中的价值。18个月时的无进展生存率是该试验的主要终点。将评估奥希替尼与吉非替尼预防脑转移的活性。

相似文献

[1]
The APPLE Trial: Feasibility and Activity of AZD9291 (Osimertinib) Treatment on Positive PLasma T790M in EGFR-mutant NSCLC Patients. EORTC 1613.

Clin Lung Cancer. 2017-9

[2]
Osimertinib treatment based on plasma T790M monitoring in patients with EGFR-mutant non-small-cell lung cancer (NSCLC): EORTC Lung Cancer Group 1613 APPLE phase II randomized clinical trial.

Ann Oncol. 2023-5

[3]
FDA Benefit-Risk Assessment of Osimertinib for the Treatment of Metastatic Non-Small Cell Lung Cancer Harboring Epidermal Growth Factor Receptor T790M Mutation.

Oncologist. 2017-12-14

[4]
Osimertinib benefit in EGFR-mutant NSCLC patients with T790M-mutation detected by circulating tumour DNA.

Ann Oncol. 2017-4-1

[5]
Preclinical Comparison of Osimertinib with Other EGFR-TKIs in EGFR-Mutant NSCLC Brain Metastases Models, and Early Evidence of Clinical Brain Metastases Activity.

Clin Cancer Res. 2016-7-19

[6]
A Phase II Trial of Osimertinib in the Second-Line Treatment of Non-small Cell Lung Cancer with the EGFR T790M Mutation, Detected from Circulating Tumor DNA: LiquidLung-O-Cohort 2.

Cancer Res Treat. 2018-9-7

[7]
Plasma ctDNA monitoring during epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor treatment in patients with EGFR-mutant non-small cell lung cancer (JP-CLEAR trial).

Jpn J Clin Oncol. 2019-6-1

[8]
A Phase II Study to Assess the Efficacy of Osimertinib in Patients With EGFR Mutation-positive NSCLC Who Developed Isolated CNS Progression (T790M-negative or Unknown) During First- or Second-generation EGFR-TKI or Systemic Disease Progression (T790M-negative) After Treatment With First- or Second-generation EGFR-TKI and Platinum-based Chemotherapy (WJOG12819L).

Clin Lung Cancer. 2021-7

[9]
Osimertinib (AZD9291) and CNS Response in Two Radiotherapy-Naïve Patients with EGFR-Mutant and T790M-Positive Advanced Non-Small Cell Lung Cancer.

Clin Drug Investig. 2016-8

[10]
Cost-effectiveness of Osimertinib in the First-Line Treatment of Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer.

JAMA Oncol. 2018-8-1

引用本文的文献

[1]
Promising Combinatorial Therapeutic Strategies against Non-Small Cell Lung Cancer.

Cancers (Basel). 2024-6-12

[2]
Circulating Tumor DNA Dynamics Fail to Predict Efficacy of Poly(ADP-ribose) Polymerase/VEGFR Inhibition in Patients With Heavily Pretreated Advanced Solid Tumors.

JCO Precis Oncol. 2024-2

[3]
Epigenetic-based combination therapy and liposomal codelivery overcomes osimertinib-resistant NSCLC via repolarizing tumor-associated macrophages.

Acta Pharmacol Sin. 2024-4

[4]
Current and future applications of liquid biopsy in non-small-cell lung cancer-a narrative review.

Transl Lung Cancer Res. 2023-3-31

[5]
Liquid Biopsies in Lung Cancer.

Cancers (Basel). 2023-2-23

[6]
T790M testing through repeated liquid biopsy over time: a real-world multicentric retrospective experience.

J Thorac Dis. 2022-9

[7]
An updated network meta-analysis of EGFR-TKIs and combination therapy in the first-line treatment of advanced EGFR mutation positive non-small cell lung cancer.

Front Oncol. 2022-8-1

[8]
Technical Validation and Clinical Implications of Ultrasensitive PCR Approaches for -Thr790Met Mutation Detection in Pretreatment FFPE Samples and in Liquid Biopsies from Non-Small Cell Lung Cancer Patients.

Int J Mol Sci. 2022-7-31

[9]
Prognostic value of integrating circulating tumour cells and cell-free DNA in non-small cell lung cancer.

Heliyon. 2022-7-19

[10]
Peruvoside is a novel Src inhibitor that suppresses NSCLC cell growth and motility by downregulating multiple Src-EGFR-related pathways.

Am J Cancer Res. 2022-6-15

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