Eli Lilly and Company, Indianapolis, IN.
Eli Lilly and Company, Indianapolis, IN.
Clin Lung Cancer. 2021 Jan;22(1):32-41.e1. doi: 10.1016/j.cllc.2020.09.011. Epub 2020 Sep 18.
Metastatic non-small cell lung cancer (mNSCLC) is characterized by complex genomic alterations. NF1 mutations may confer distinct clinical characteristics within NSCLC, and real-world evidence on concurrent mutations, treatment patterns, and health outcomes is lacking.
This retrospective study was performed in patients with mNSCLC treated in the Flatiron Health network who underwent the FoundationOne tumor-sequencing. Anticancer therapies, concurrent mutations, real-world progression-free survival (rwPFS), and overall survival (OS) were assessed.
Of the 1663 patients, 103 patients were identified with NF1 mutation. Concurrent mutations with Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (16.5%) and epidermal growth factor receptor fusion (6.8%) were the most frequent. In patients with NF1 mutation only (n = 57), 42% were women, 86% patients had smoking history, and 70% had non-squamous cell carcinoma type. Most (51%) of the patients with NF1 mutations received a single line of therapy versus other mutations and the overall treated population (44%). Platinum-based chemotherapy was the predominant first-line therapy, with programmed cell death-1/programmed cell death-ligand-1 inhibitors as subsequent lines of therapy. The NF1 mutation only group had numerically the shortest median rwPFS (82 days) than other mutation groups. Median OS for the NF1 mutation group in first, second, and third lines of therapy was 321, 498, and 210 days, respectively.
NF1 mutations confer distinct clinical characteristics in patients with mNSCLC. These patients may have different trajectories for progression and survival than seen for other mutations, experience less systemic therapy after first-line therapy, and may have shorter survival.
转移性非小细胞肺癌（mNSCLC）的特征是存在复杂的基因组改变。NF1 突变可能会赋予 NSCLC 患者独特的临床特征，但目前缺乏关于同时存在的突变、治疗模式和健康结果的真实世界证据。
本回顾性研究纳入了在接受 FoundationOne 肿瘤测序的 Flatiron Health 网络中治疗的 mNSCLC 患者，评估了抗癌治疗、同时存在的突变、真实世界无进展生存期（rwPFS）和总生存期（OS）。
在 1663 名患者中，发现 103 名患者存在 NF1 突变。最常见的同时存在的突变是 Ki-ras2 克氏大鼠肉瘤病毒致癌基因同源物（16.5%）和表皮生长因子受体融合（6.8%）。仅存在 NF1 突变的患者（n=57）中，42%为女性，86%有吸烟史，70%为非鳞状细胞癌类型。与其他突变和整体治疗人群（44%）相比，存在 NF1 突变的患者中有 51%接受了单一线治疗。铂类化疗是主要的一线治疗，随后是程序性细胞死亡蛋白-1/程序性细胞死亡配体-1 抑制剂。仅存在 NF1 突变的患者的 rwPFS 中位数（82 天）短于其他突变组。NF1 突变组在一线、二线和三线治疗中的中位 OS 分别为 321、498 和 210 天。
NF1 突变赋予 mNSCLC 患者独特的临床特征。与其他突变相比，这些患者的进展和生存轨迹可能不同，一线治疗后接受的系统治疗较少，生存时间可能较短。
