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巩固性 durvalumab 在 EGFR 和 HER2 突变不可切除 III 期 NSCLC 患者中的作用。

Role of Consolidation Durvalumab in Patients With EGFR- and HER2-Mutant Unresectable Stage III NSCLC.

机构信息

Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford California.

Division of Oncology, Department of Medicine, Stanford Cancer Institute, Stanford University School of Medicine, Stanford California; Veterans Affairs Palo Alto Healthcare System, Palo Alto, California.

出版信息

J Thorac Oncol. 2021 May;16(5):868-872. doi: 10.1016/j.jtho.2020.12.020. Epub 2021 Feb 1.

Abstract

INTRODUCTION

Despite the recent advance of consolidation durvalumab in the treatment of unresectable stage III NSCLC, not every patient benefits from durvalumab and the predictive markers of response have been difficult to identify.

METHODS

We performed a retrospective analysis of patients with unresectable stage III NSCLC treated with consolidation durvalumab after definitive chemoradiation from January 2018 to March 2020.

RESULTS

A total of 36 patients with unresectable stage III NSCLC were treated with consolidation durvalumab. Of these patients, 14 had tumor mutations in the ERBB family including 11 EGFR and 3 ERBB2. The ERBB2/EGFR tumor mutation cohort was more likely to be nonsmokers; otherwise, the two groups were similar in age, sex, programmed death-ligand 1 expression, and type of previous chemotherapy regimen. Patients in the ERBB2/EGFR cohort had a significantly shorter disease-free survival compared with the EGFR or ERBB2 wild-type cohort (7.5 mo versus not reached, p = 0.04).

CONCLUSIONS

Consolidation durvalumab seems to be less efficacious in patients with ERBB2/EGFR-mutant tumors. Future work should seek to evaluate this in the prospective setting and provide insight into the optimal treatment of ERBB2/EGFR-mutant stage III NSCLC.

摘要

简介

尽管 durvalumab 在不可切除 III 期 NSCLC 的治疗方面最近取得了进展,但并非每个患者都能从 durvalumab 中获益,且反应的预测标志物也难以确定。

方法

我们对 2018 年 1 月至 2020 年 3 月期间接受巩固 durvalumab 治疗的不可切除 III 期 NSCLC 患者进行了回顾性分析。

结果

共有 36 例不可切除 III 期 NSCLC 患者接受了巩固 durvalumab 治疗。其中 14 例患者存在 ERBB 家族肿瘤突变,包括 11 例 EGFR 和 3 例 ERBB2。ERBB2/EGFR 肿瘤突变组更倾向于非吸烟者;除此之外,两组在年龄、性别、程序性死亡配体 1 表达和先前化疗方案类型方面相似。ERBB2/EGFR 组的无疾病进展生存期明显短于 EGFR 或 ERBB2 野生型组(7.5 个月与未达到,p = 0.04)。

结论

巩固 durvalumab 似乎对 ERBB2/EGFR 突变型肿瘤患者的疗效较差。未来的研究工作应在前瞻性研究中评估这一点,并深入了解 ERBB2/EGFR 突变型 III 期 NSCLC 的最佳治疗方法。

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