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EGFR 突变型晚期 NSCLC 患者接受 TKI 治疗后的血液学参数:预测生存和毒性。

Hematological parameters in EGFR-mutated advanced NSCLC patients treated with TKIs: predicting survival and toxicity.

机构信息

Clinic for Medical Oncology, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.

Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Expert Rev Anticancer Ther. 2021 Jun;21(6):673-679. doi: 10.1080/14737140.2021.1893694. Epub 2021 Mar 1.

Abstract

: The aim of this study was to analyze the prognostic value of pre-treatment hematological parameters in -mutated non-small cell lung cancer patients treated with tyrosine-kinase inhibitors (TKIs).: Patients with mutations were treated with EGFR-TKIs in the first line until progression/unacceptable toxicity. Hematological parameters were derived from the absolute baseline differential counts of a complete blood count. The associations between the patients' and tumor characteristics were analyzed using Pearson Chi-Square, Fisher's exact, t-test, and Mann-Whitney tests. Cutoff values were determined using ROC curves, and correlation with survival was examined by Kaplan-Meier method and Cox regression.: Patients with NMR<12.62 had a longer PFS compared to patients with higher NMR values (12.0 vs. 10.0 months, p = 0.054) and a significantly longer OS (20.0 vs. 11.0 months, p = 0.010). The same parameter was confirmed as a predictors of favorable response in the patient subgroup with activating mutations. Patients with NLR>2.9 and LMR<2.5 more often presented with paronichia and diarrhea, and patients with PLR>190 more often had paronichia, diarrhea and hyperbilirubinemia.: Low baseline value of the hematological parameter NMR has shown potential as a routine, low-cost, and minimally invasive predictor of survival in EGFR-TKI-treated NSCLC patients.

摘要

: 本研究旨在分析经酪氨酸激酶抑制剂 (TKI) 治疗的 - 突变非小细胞肺癌患者治疗前血液学参数的预后价值。: 携带 突变的患者接受 EGFR-TKI 一线治疗,直至疾病进展/无法耐受毒性。血液学参数来自全血细胞计数的绝对基线差异计数。采用 Pearson Chi-Square、Fisher's exact、t 检验和 Mann-Whitney 检验分析患者与肿瘤特征之间的关系。使用 ROC 曲线确定临界值,并通过 Kaplan-Meier 方法和 Cox 回归检查与生存的相关性。: NMR<12.62 的患者与 NMR 值较高的患者相比,无进展生存期(PFS)更长(12.0 个月比 10.0 个月,p = 0.054),总生存期(OS)更长(20.0 个月比 11.0 个月,p = 0.010)。在携带激活 突变的患者亚组中,该参数也被证实是预测有利反应的指标。NLR>2.9 和 LMR<2.5 的患者更容易出现甲沟炎和腹泻,PLR>190 的患者更容易出现甲沟炎、腹泻和高胆红素血症。: 基线血液学参数 NMR 值较低表明其可能作为一种常规、低成本、微创的预测指标,用于评估 EGFR-TKI 治疗的非小细胞肺癌患者的生存情况。

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