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免疫检查点抑制剂单药或联合化疗治疗携带有 ERBB2 突变的 NSCLC 的疗效。

Efficacy of Immune Checkpoint Inhibitors Alone or in Combination With Chemotherapy in NSCLC Harboring ERBB2 Mutations.

机构信息

Clinic for Internal Medicine I, University Hospital, Technische Universität Dresden, Dresden, Germany.

Department for Pathology, University Hospital, Technische Universität Dresden, Dresden, Germany.

出版信息

J Thorac Oncol. 2021 Nov;16(11):1952-1958. doi: 10.1016/j.jtho.2021.06.025. Epub 2021 Jul 8.

Abstract

INTRODUCTION

In contrast to other driver mutations, no targeted therapies have yet been approved in ERBB2-mutated NSCLC (HER2mu NSCLC). Nevertheless, several compounds have revealed promising early efficacy data, which need to be evaluated in the context of current standard approaches. Although data on the efficacy of immune checkpoint inhibitors (ICIs) in second or subsequent lines of treatment remain limited and conflicting, there are virtually no data on patient outcome under ICI/platinum-doublet combinations in the first-line setting.

METHODS

We retrospectively evaluated outcomes of patients with HER2mu NSCLC treated with ICI alone or in combination with chemotherapy within the German National Network Genomic Medicine Lung Cancer consortium by means of overall response rate (ORR), progression-free survival (PFS), and overall survival (OS).

RESULTS

ICI either in combination with chemotherapy or as monotherapy was applied as first-line treatment in 27 patients, whereas 34 received single-agent ICI in second or subsequent lines. Patient characteristics were in line with previously published data. In treatment-naive patients receiving ICI in combination with chemotherapy, the ORR, median PFS, and OS rate at 1 year were 52%, 6 months, and 88%, respectively. In second or subsequent lines, ICI monotherapy was associated with an ORR of 16%, a median PFS of 4 months, and a median OS of 10 months.

CONCLUSIONS

ICIs are effective as monotherapy and in combination with platinum-doublet chemotherapy. Therefore, ICI-based treatments may be found as the current standard of care and benchmark for targeted therapies in HER2mu NSCLC.

摘要

简介

与其他驱动基因突变相比,针对 ERBB2 突变的非小细胞肺癌(HER2mu NSCLC)尚未批准任何靶向治疗方法。然而,几种化合物已经显示出有希望的早期疗效数据,这些数据需要在当前标准方法的背景下进行评估。尽管二线或后续治疗中免疫检查点抑制剂(ICI)疗效的数据仍然有限且存在冲突,但在一线治疗中,ICI/铂类双重联合治疗的患者结局实际上几乎没有数据。

方法

我们通过总缓解率(ORR)、无进展生存期(PFS)和总生存期(OS),回顾性评估了德国国家基因组医学肺癌网络联盟中 HER2mu NSCLC 患者接受 ICI 单药或联合化疗治疗的结果。

结果

ICI 联合化疗或单药作为一线治疗应用于 27 例患者,而 34 例患者接受二线或后续线单药 ICI 治疗。患者特征与先前发表的数据一致。在接受 ICI 联合化疗的初治患者中,ORR、中位 PFS 和 1 年 OS 率分别为 52%、6 个月和 88%。在二线或后续线,ICI 单药治疗的 ORR 为 16%,中位 PFS 为 4 个月,中位 OS 为 10 个月。

结论

ICI 作为单药和联合铂类双重化疗均有效。因此,ICI 为基础的治疗可能成为 HER2mu NSCLC 的当前标准治疗方法和靶向治疗的基准。

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