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一线酪氨酸激酶抑制剂(TKI)治疗晚期非小细胞肺癌后的初步疗效与预后的关系。

The relationship between preliminary efficacy and prognosis after first-line tyrosine kinase inhibitor (-TKI) treatment of advanced non-small cell lung cancer.

作者信息

Chen Dongfang, Chu Tianqing, Chang Qing, Zhang Yanwei, Xiong Liwen, Qiao Rong, Teng Jiajun, Han Baohui, Zhong Runbo

机构信息

Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200000, China.

出版信息

Ann Transl Med. 2019 May;7(9):195. doi: 10.21037/atm.2019.04.06.

Abstract

BACKGROUND

Nowadays, patients with tyrosine kinase inhibitor (-TKI)-sensitive advanced non-small cell lung cancer (NSCLC) receive -TKIs as first-line treatment. We aimed to analyze the relationship between preliminary efficacy (tumor shrinkage within 1 month) and progression-free survival (PFS) after first-line -TKI treatment.

METHODS

A total of 82 patients with -TKI-sensitive advanced NSCLC confirmed by histopathology from January 2013 to January 2017 were retrospectively analyzed. All patients received first-line -TKI treatment and follow-up at Shanghai Chest Hospital.

RESULTS

Of a total of 82 patients, 42 (51.2%) patients achieved partial response (PR) within 1 month, and 40 (48.8%) patients achieved stable disease (SD: -30% to 0) within 1 month. The median PFS among all patients was 10 months. The median PFS in patients achieving PR within 1 month was 10.0 months. The median PFS in patients achieving SD (-30% to 0) within 1 month was 9.3 months. There was no statistically significant difference between PR within 1 month and SD (-30% to 0) within 1 month (P=0.620). In the -sensitive mutation subgroup, there was also no statistically significant difference between PR within 1 month and SD (-30% to 0) within 1 month. Univariate and multivariate analysis of first-line -TKI treatment showed that age, mutation type, and T staging had effects on PFS. Patients who were more than 65 years old, had 19del mutation, along with a T staging less than 4, had a longer PFS; these differences were statistically significant. Liver metastasis, bone metastasis, and brain metastasis were not shown to be related to PFS.

CONCLUSIONS

For patients with -TKI-sensitive advanced NSCLC, there is no correlation between preliminary efficacy (tumor shrinkage within 1 month) and PFS after first-line -TKI treatment.

摘要

背景

目前,酪氨酸激酶抑制剂(-TKI)敏感的晚期非小细胞肺癌(NSCLC)患者接受-TKIs作为一线治疗。我们旨在分析一线-TKI治疗后初步疗效(1个月内肿瘤缩小)与无进展生存期(PFS)之间的关系。

方法

回顾性分析2013年1月至2017年1月期间82例经组织病理学确诊的-TKI敏感的晚期NSCLC患者。所有患者均在上海胸科医院接受一线-TKI治疗及随访。

结果

82例患者中,42例(51.2%)在1个月内达到部分缓解(PR),40例(48.8%)在1个月内达到疾病稳定(SD:-30%至0)。所有患者的中位PFS为10个月。1个月内达到PR的患者中位PFS为10.0个月。1个月内达到SD(-30%至0)的患者中位PFS为9.3个月。1个月内的PR与1个月内的SD(-30%至0)之间无统计学显著差异(P = 0.620)。在敏感突变亚组中,1个月内的PR与1个月内的SD(-30%至0)之间也无统计学显著差异。一线-TKI治疗的单因素和多因素分析显示,年龄、突变类型和T分期对PFS有影响。年龄超过65岁、有19del突变且T分期小于4的患者PFS较长;这些差异具有统计学显著性。肝转移、骨转移和脑转移与PFS无关。

结论

对于-TKI敏感的晚期NSCLC患者,一线-TKI治疗后的初步疗效(1个月内肿瘤缩小)与PFS之间无相关性。

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