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奥希替尼治疗 T790M 阳性晚期非小细胞肺癌患者:来自 II 期研究的韩国亚组分析。

Osimertinib in Patients with T790M-Positive Advanced Non-small Cell Lung Cancer: Korean Subgroup Analysis from Phase II Studies.

机构信息

Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Center for Lung Cancer, National Cancer Center, Goyang, Korea.

出版信息

Cancer Res Treat. 2020 Jan;52(1):284-291. doi: 10.4143/crt.2019.200. Epub 2019 Jul 23.

Abstract

PURPOSE

Osimertinib is a third-generation, irreversible, oral epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that potently and selectively inhibits both EGFR sensitizing mutation and EGFR T790M and has demonstrated efficacy in non-small cell lung cancer (NSCLC) central nervous system (CNS) metastases. We present results of a subgroup analysis of Korean patients from the pooled data of two global phase II trials: AURA extension (NCT01802632) and AURA2 (NCT02094261).

MATERIALS AND METHODS

Enrolled patients had EGFR T790M-positive NSCLC and disease progression during or after EGFR-TKI therapy. Patients received osimertinib 80 mg orally once daily until disease progression. The primary endpoint was objective response rate (ORR).

RESULTS

In total, 66 Korean patients received osimertinib treatment with a median treatment duration of 19 months. In the evaluable-for-response population (n=62), ORR was 74% (95% confidence interval [CI], 61.5 to 84.5) and median duration of response was 9.8 months (95% CI, 7.1 to 16.8). In the full analysis set (n=66), median progression-free survival was 10.9 months (95% CI, 8.3 to 15.0; data cutoff November 1, 2016), and median overall survival was 29.2 months (95% CI, 24.8 to 35.7; data cutoff May 1, 2018). Eight patients with CNS metastases were evaluable for response, none of whom showed CNS progression. The most common adverse events were rash (53%), cough (33%), paronychia, diarrhea, and decreased appetite (each 32%).

CONCLUSION

Efficacy and safety profiles of osimertinib in this subgroup are consistent with the global phase II pooled population, which supports osimertinib as a recommended treatment for Korean patients with T790M positive NSCLC.

摘要

目的

奥希替尼是一种第三代、不可逆的、口服表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI),能够强效和选择性地抑制 EGFR 敏感突变和 EGFR T790M,在非小细胞肺癌(NSCLC)中枢神经系统(CNS)转移中显示出疗效。我们报告了来自两项全球 II 期试验(AURA 扩展[NCT01802632]和 AURA2[NCT02094261])的汇总数据中韩国患者的亚组分析结果。

材料和方法

入组患者患有 EGFR T790M 阳性 NSCLC,并且在 EGFR-TKI 治疗期间或之后疾病进展。患者接受奥希替尼 80 mg 口服,每日一次,直至疾病进展。主要终点是客观缓解率(ORR)。

结果

共有 66 名韩国患者接受奥希替尼治疗,中位治疗时间为 19 个月。在可评估反应人群(n=62)中,ORR 为 74%(95%置信区间[CI],61.5 至 84.5),中位缓解持续时间为 9.8 个月(95%CI,7.1 至 16.8)。在全分析集(n=66)中,中位无进展生存期为 10.9 个月(95%CI,8.3 至 15.0;数据截止日期为 2016 年 11 月 1 日),中位总生存期为 29.2 个月(95%CI,24.8 至 35.7;数据截止日期为 2018 年 5 月 1 日)。8 名有 CNS 转移的患者可评估反应,无 1 例出现 CNS 进展。最常见的不良反应是皮疹(53%)、咳嗽(33%)、甲沟炎、腹泻和食欲下降(各 32%)。

结论

奥希替尼在该亚组中的疗效和安全性特征与全球 II 期汇总人群一致,支持奥希替尼作为 T790M 阳性 NSCLC 韩国患者的推荐治疗药物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c83e/6962491/c62728917f0f/crt-2019-200f1.jpg

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