表皮生长因子受体突变型非小细胞肺癌患者接受免疫检查点抑制剂治疗获益的特征。
Characteristics of patients with EGFR-mutant non-small-cell lung cancer who benefited from immune checkpoint inhibitors.
机构信息
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.
出版信息
Cancer Immunol Immunother. 2021 Jan;70(1):101-106. doi: 10.1007/s00262-020-02662-0. Epub 2020 Jul 10.
OBJECTIVES
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.
PATIENTS AND METHODS
The medical records of NSCLC patients with EGFR mutations who received PD-1/PD-L1 antibody monotherapy at nine institutions were reviewed.
RESULTS
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).
CONCLUSION
The duration of response to prior EGFR TKIs could be a predictive marker of ICI therapy in EGFR-mutant NSCLC patients.
目的
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。
患者和方法
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。
结果
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）。
结论
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。
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