Wang Lulu, Li Yan, Li Luchun, Wu Zhijuan, Yang Dan, Ma Huiwen, Wang Donglin
Oncology Department, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Shapingba District, Chongqing, China.
Onco Targets Ther. 2018 Apr 26;11:2345-2353. doi: 10.2147/OTT.S157755. eCollection 2018.
This study was conducted to compare the efficacy of a combination of icotinib and chemotherapy with icotinib or chemotherapy alone in untreated non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR)-sensitive mutations and to analyze the curative effect of different treatments on different genetic mutations (EGFR 19 exon deletion and L858R mutation) in a real-life setting.
One hundred ninety-one patients were studied in this retrospective analysis from January 2013 to December 2015. The baseline characteristics, curative effects and adverse events of patients were analyzed. The primary endpoint was progression free survival (PFS).
Longer PFS and overall survival (OS), and better objective response rate (ORR) were observed in the combination group compared to icotinib or chemotherapy along. For patients with an EGFR 19 exon deletion, the PFS, OS, and ORR in the combination group were superior to those in the icotinib or chemotherapy group. For the patients with the EGFR L858R mutation, better PFS and ORR were observed in the combination group, but OS was not obviously prolonged. Grade 3 or 4 adverse events were most commonly reported with combination therapy or chemotherapy alone. No possible drug-related interstitial lung disease or of drug related deaths occurred.
The combination of icotinib and chemotherapy in patients with untreated NSCLC harboring sensitive EGFR mutations resulted in improved PFS and OS, especially in those who harbored the EGFR exon 19 deletion.
本研究旨在比较埃克替尼与化疗联合用药与埃克替尼单药或化疗单药治疗表皮生长因子受体(EGFR)敏感突变的初治非小细胞肺癌(NSCLC)患者的疗效,并在实际临床环境中分析不同治疗方法对不同基因突变(EGFR 19外显子缺失和L858R突变)的治疗效果。
本回顾性分析纳入了2013年1月至2015年12月期间的191例患者。分析患者的基线特征、疗效及不良事件。主要终点为无进展生存期(PFS)。
与埃克替尼单药或化疗单药相比,联合治疗组观察到更长的PFS和总生存期(OS),以及更好的客观缓解率(ORR)。对于EGFR 19外显子缺失的患者,联合治疗组的PFS、OS和ORR均优于埃克替尼单药组或化疗组。对于EGFR L858R突变的患者,联合治疗组观察到更好的PFS和ORR,但OS未明显延长。3级或4级不良事件最常见于联合治疗或化疗单药治疗。未发生可能与药物相关的间质性肺病或药物相关死亡。
埃克替尼与化疗联合治疗初治的EGFR敏感突变NSCLC患者可改善PFS和OS,尤其是对于EGFR 19外显子缺失的患者。