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EGFR-TKI 重挑战治疗在携带药物敏感 EGFR 突变的老年晚期非小细胞肺癌患者中的疗效和安全性。

Effectiveness and Safety of EGFR-TKI Rechallenge Treatment in Elderly Patients with Advanced Non-Small-Cell Lung Cancer Harboring Drug-Sensitive EGFR Mutations.

机构信息

Department of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama 309-1793, Ibaraki, Japan.

Department of Respiratory Medicine, Comprehensive Cancer Center, International Medical Center, Saitama University Hospital, Hidaka 350-1298, Saitama, Japan.

出版信息

Medicina (Kaunas). 2021 Sep 3;57(9):929. doi: 10.3390/medicina57090929.

Abstract

: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are effective first-line chemotherapeutic agents for patients with advanced non-small-cell lung cancer (NSCLC) harboring drug-sensitive mutations. However, the effectiveness of EGFR-TKI rechallenge after first-line EGFR-TKI treatment is not sufficient in elderly patients (over 75 years of age) harboring drug-sensitive mutations. Therefore, we investigated the effectiveness and safety of EGFR-TKI rechallenge after first-line EGFR-TKI treatment in elderly patients with advanced NSCLC harboring drug-sensitive mutations. : Between April 2008 and December 2015, we analyzed 78 elderly patients with advanced NSCLC harboring drug-sensitive mutations with first-line EGFR-TKI treatment at four Japanese institutions. We retrospectively evaluated the clinical effectiveness and safety profiles of EGFR-TKI rechallenge after first-line EGFR-TKI treatment in elderly patients with advanced NSCLC harboring drug-sensitive mutations (exon 19 deletion/exon 21 L858R mutation). : Twenty-two patients in the cohort were rechallenged with EGFR-TKI. The median age was 79.5 years (range 75-87 years). Despite the fact that it was a retrospective analysis, even with EGFR-TKI rechallenge treatment the response rate was 23%, progression-free survival was 5.3 months, and overall survival was 14.4 months. Common adverse events included rash acneiform, paronychia, diarrhea, and anorexia. There were no treatment-related deaths. Due to the occurrence of adverse events of grade 2 or more, dose reduction was performed in 15 (68.2%) of 22 cases. : EGFR-TKI rechallenge treatment after first-line EGFR-TKI treatment in elderly patients with advanced NSCLC harboring drug-sensitive mutations was one of the limited, safe and effective treatment options for elderly -positive lung cancer patients.

摘要

表皮生长因子受体-酪氨酸激酶抑制剂(EGFR-TKIs)是携带药物敏感突变的晚期非小细胞肺癌(NSCLC)患者的有效一线化疗药物。然而,在携带药物敏感突变的老年患者(75 岁以上)中,一线 EGFR-TKI 治疗后 EGFR-TKI 再挑战的疗效并不理想。因此,我们研究了携带药物敏感突变的晚期 NSCLC 老年患者一线 EGFR-TKI 治疗后 EGFR-TKI 再挑战的有效性和安全性。

在 2008 年 4 月至 2015 年 12 月期间,我们在四家日本机构分析了 78 例携带药物敏感突变的晚期 NSCLC 老年患者的一线 EGFR-TKI 治疗情况。我们回顾性评估了携带药物敏感突变(外显子 19 缺失/外显子 21 L858R 突变)的晚期 NSCLC 老年患者一线 EGFR-TKI 治疗后 EGFR-TKI 再挑战的临床有效性和安全性特征。

队列中有 22 例患者接受了 EGFR-TKI 再挑战。中位年龄为 79.5 岁(范围 75-87 岁)。尽管这是一项回顾性分析,但即使进行 EGFR-TKI 再挑战治疗,缓解率仍为 23%,无进展生存期为 5.3 个月,总生存期为 14.4 个月。常见的不良反应包括皮疹痤疮样、甲沟炎、腹泻和厌食。无治疗相关死亡。由于发生 2 级或以上不良反应,22 例中有 15 例(68.2%)减少了剂量。

携带药物敏感突变的晚期 NSCLC 老年患者一线 EGFR-TKI 治疗后 EGFR-TKI 再挑战治疗是老年阳性肺癌患者的一种有限、安全有效的治疗选择之一。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18c2/8466413/bff5282527a6/medicina-57-00929-g001.jpg

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