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奥希替尼治疗 T790M 阳性晚期非小细胞肺癌日本患者:一项汇总亚组分析。

Osimertinib for Japanese patients with T790M-positive advanced non-small-cell lung cancer: A pooled subgroup analysis.

机构信息

Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino-city, Osaka, Japan.

Department of Thoracic Oncology, Hyogo Cancer Center, Akashi, Hyogo, Japan.

出版信息

Cancer Sci. 2019 Sep;110(9):2884-2893. doi: 10.1111/cas.14120. Epub 2019 Aug 1.

Abstract

Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are the standard of care for non-small-cell lung cancer (NSCLC) patients harboring EGFR mutations. However, almost all patients develop resistance after approximately 1 y of treatment, with >50% of cases due to the T790M secondary mutation of the EGFR gene. A large global Phase III study (AURA3) demonstrated that osimertinib significantly prolonged progression-free survival (PFS) over platinum-doublet chemotherapy in patients with T790M-positive NSCLC who had progressed on previous EGFR-TKI therapy. However, it is not clear whether efficacy or safety of osimertinib in Japanese patients is similar to the overall population. We report a pre-planned subgroup analysis of pooled Phase II data from the AURA Extension and AURA2 trials to investigate the efficacy and safety of osimertinib in Japanese patients. This study included 81 Japanese patients. Patients were administered 80 mg osimertinib orally once daily until disease progression. The main endpoints were objective response rate (ORR), PFS, and safety. The ORR was 63.6% and median PFS was 13.8 mo. Overall survival rate at 36 mo was 54.0%. The most common all-cause adverse events (AEs) were rash (grouped term; 65.4%), diarrhea (51.9%), paronychia (grouped term; 49.4%), and dry skin (grouped term; 39.5%). Most AEs were grade 1-2. Five patients (6.2%) developed interstitial lung disease, resulting in two deaths (2.5%). Osimertinib demonstrated favorable ORR and PFS in Japanese patients, similar to the overall population. Additionally, osimertinib has good efficacy and a manageable safety profile in Japanese patients with NSCLC who had acquired resistance due to the T790M mutation.

摘要

表皮生长因子受体 (EGFR)-酪氨酸激酶抑制剂 (TKI) 是携带 EGFR 突变的非小细胞肺癌 (NSCLC) 患者的标准治疗方法。然而,几乎所有患者在治疗约 1 年后都会产生耐药性,其中超过 50%的病例是由于 EGFR 基因的 T790M 继发突变。一项大型全球 III 期研究 (AURA3) 表明,奥希替尼显著延长了先前 EGFR-TKI 治疗进展后 T790M 阳性 NSCLC 患者的无进展生存期 (PFS),与铂类双联化疗相比。然而,奥希替尼在日本患者中的疗效或安全性是否与总体人群相似尚不清楚。我们报告了 AURA 扩展和 AURA2 试验的汇总 II 期数据的预先计划的亚组分析,以研究奥希替尼在日本患者中的疗效和安全性。这项研究包括 81 名日本患者。患者每天口服 80mg 奥希替尼,直至疾病进展。主要终点是客观缓解率 (ORR)、无进展生存期 (PFS) 和安全性。ORR 为 63.6%,中位 PFS 为 13.8 个月。36 个月的总生存率为 54.0%。最常见的全因不良事件 (AE) 是皮疹 (分组术语;65.4%)、腹泻 (51.9%)、甲沟炎 (分组术语;49.4%) 和皮肤干燥 (分组术语;39.5%)。大多数 AE 为 1-2 级。5 名患者 (6.2%) 发生间质性肺病,导致 2 例死亡 (2.5%)。奥希替尼在日本患者中显示出良好的 ORR 和 PFS,与总体人群相似。此外,奥希替尼在 T790M 突变导致获得性耐药的日本 NSCLC 患者中具有良好的疗效和可管理的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c07/6726692/2f7907831658/CAS-110-2884-g001.jpg

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