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m期非小细胞肺癌真实世界患者的特征、治疗模式、检测模式及结局研究。

Study of patient characteristics, treatment patterns, testing patterns and outcomes in real-world patients with m non-small cell lung cancer.

作者信息

Winfree Katherine B, Sheffield Kristin M, Cui Zhanglin Lin, Sugihara Tomoko, Feliciano Josephine

机构信息

Eli Lilly and Company, Indianapolis, IN, USA.

Syneos Health, Morrisville, NC, USA.

出版信息

Curr Med Res Opin. 2022 Jan;38(1):91-99. doi: 10.1080/03007995.2021.1983530. Epub 2021 Oct 12.

Abstract

OBJECTIVE

This retrospective, observational study examined patient characteristics, treatment patterns, testing patterns, and outcomes of US patients receiving first-/second- or third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).

METHODS

This study used an electronic health record-derived de-identified database. Eligible patients had advanced m non-small cell lung cancer. Descriptive statistics were used to describe demographic, clinical, and treatment characteristics. Logistic regression models were used to identify patient characteristics that were associated with the use of osimertinib vs. a first-/second-generation EGFR TKI. Kaplan-Meier methods were used for survival analysis.

RESULTS

Of the 782 patients who received first-line (1L) therapy with first-/second-generation EGFR TKIs in cohort A, erlotinib was the most common (58%), and osimertinib was the most widely prescribed second-line (2L) therapy (52%). Of the patients who received 1L therapy with osimertinib, a greater range of treatments were prescribed in 2L. A third of patients treated with first-/second-generation EGFR TKIs underwent testing near the end of 1L, and 44% of these patients had T790M positive disease. The median time on targeted therapy (TTT) of the cohort was 11.1 months (95% confidence interval [CI] 9.7, 12.3), and the median overall survival from the start of 1L therapy was 23.5 months (95% CI 20.7, 24.8).

CONCLUSIONS

The majority of patients treated with first-/second-generation EGFR TKIs went on to receive osimertinib in the 2L setting, but overall, only a third of patients had received molecular testing at progression. Improved testing frequency is vital to inform treatment decisions.

摘要

目的

这项回顾性观察研究考察了接受第一代/第二代或第三代表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKIs)治疗的美国患者的特征、治疗模式、检测模式及治疗结果。

方法

本研究使用了一个源自电子健康记录的去识别数据库。符合条件的患者患有晚期非小细胞肺癌。采用描述性统计来描述人口统计学、临床和治疗特征。使用逻辑回归模型来确定与使用奥希替尼对比第一代/第二代EGFR TKI相关的患者特征。采用Kaplan-Meier方法进行生存分析。

结果

在队列A中,782例接受第一代/第二代EGFR TKIs一线(1L)治疗的患者中,厄洛替尼最为常用(58%),而奥希替尼是最广泛应用的二线(2L)治疗药物(52%)。在接受奥希替尼1L治疗的患者中,2L治疗的处方范围更广。接受第一代/第二代EGFR TKIs治疗的患者中有三分之一在1L治疗接近结束时接受了检测,其中44%的患者T790M呈阳性。该队列的靶向治疗中位时间(TTT)为11.1个月(95%置信区间[CI]9.7,12.3),从1L治疗开始的中位总生存期为23.5个月(95%CI 20.7,24.8)。

结论

大多数接受第一代/第二代EGFR TKIs治疗的患者在2L治疗中继续接受奥希替尼治疗,但总体而言,只有三分之一的患者在疾病进展时接受了分子检测。提高检测频率对于指导治疗决策至关重要。

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