Department of Allergy and Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama City, Okayama, 700-8558, Japan.
Department of Thoracic Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Cancer Immunol Immunother. 2021 Jan;70(1):101-106. doi: 10.1007/s00262-020-02662-0. Epub 2020 Jul 10.
Immune checkpoint inhibitors (ICIs) are less effective in non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations. However, a small percentage of patients with EGFR-mutant NSCLC do respond, and the characteristics of these patients are not known. Here, we identify the characteristics of patients who may respond to ICI therapy for EGFR-mutant NSCLC.
The medical records of NSCLC patients with EGFR mutations who received PD-1/PD-L1 antibody monotherapy at nine institutions were reviewed.
In total, 58 patients with EGFR-mutant NSCLC were analyzed. Various clinical factors such as smoking history and EGFR mutation type were not associated with progression-free survival (PFS) of ICIs, while the PFS of prior EGFR tyrosine kinase inhibitors (TKIs) was inversely associated with that of ICIs. Patients who responded to prior EGFR TKIs for > 10 months exhibited a significantly shorter response to ICIs compared to those who had responded for ≤ 10 months (PFS of ICI: 1.6 vs. 1.9 months; hazard ratio: 2.54; 95% confidence interval 1.26-5.12; p = 0.009). However, patients who responded to ICIs for > 6 months responded to prior EGFR TKIs for significantly shorter periods compared to those who responded to ICIs for ≤ 6 months (PFS of prior EGFR TKI: 5.3 vs. 12.1 months; log-rank test: p = 0.0025).
The duration of response to prior EGFR TKIs could be a predictive marker of ICI therapy in EGFR-mutant NSCLC patients.
免疫检查点抑制剂（ICI）在表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）患者中的疗效较低。然而，一小部分 EGFR 突变型 NSCLC 患者确实有反应，这些患者的特征尚不清楚。在这里，我们确定了可能对 EGFR 突变型 NSCLC 的 ICI 治疗有反应的患者的特征。
回顾了九家机构接受 PD-1/PD-L1 抗体单药治疗的 EGFR 突变型 NSCLC 患者的病历。
共分析了 58 例 EGFR 突变型 NSCLC 患者。各种临床因素，如吸烟史和 EGFR 突变类型，与 ICI 的无进展生存期（PFS）无关，而先前的 EGFR 酪氨酸激酶抑制剂（TKI）的 PFS 与 ICI 的 PFS 呈负相关。先前 EGFR TKI 治疗>10 个月的患者对 ICI 的反应明显短于治疗≤10 个月的患者（ICI 的 PFS：1.6 与 1.9 个月；危险比：2.54；95%置信区间 1.26-5.12；p=0.009）。然而，对 ICI 治疗>6 个月有反应的患者对先前 EGFR TKI 的反应时间明显短于对 ICI 治疗≤6 个月的患者（先前 EGFR TKI 的 PFS：5.3 与 12.1 个月；对数秩检验：p=0.0025）。
先前 EGFR TKI 治疗的反应持续时间可能是 EGFR 突变型 NSCLC 患者 ICI 治疗的预测标志物。
