奥立莫单抗残留疾病与 EGFR 突变型非小细胞肺癌 EGFR-TKI 治疗期间失败模式的相关性：一项回顾性研究。

Association between oligo-residual disease and patterns of failure during EGFR-TKI treatment in EGFR-mutated non-small cell lung cancer: a retrospective study.

机构信息

Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

Department of Respiratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.

出版信息

BMC Cancer. 2021 Nov 19;21(1):1247. doi: 10.1186/s12885-021-08983-2.

DOI:10.1186/s12885-021-08983-2

PMID:34798865

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8605535/

Abstract

BACKGROUND

Local ablative therapy (LAT) may be beneficial for patients with epidermal growth factor receptor (EGFR) mutated non-small cell lung cancer (NSCLC) with oligo-residual disease after treatment with EGFR tyrosine kinase inhibitor (EGFR-TKI). However, this has not been fully established. This study aimed to evaluate the predominant progressive disease (PD) pattern limited to residual sites of disease after treatment with EGFR-TKI.

METHODS

Patients with advanced EGFR-mutated NSCLC treated with EGFR-TKIs as first-line therapy were retrospectively analysed during a 7-year period. Oligo-residual disease was defined as the presence of 1 - 4 lesions (including the primary site) at 3 months from the start of EGFR-TKI treatment. The predictive factors of PD patterns after EGFR-TKI treatment were evaluated.

RESULTS

A total of 207 patients were included. Three months after the start of EGFR-TKI treatment, 66 patients (32%) had oligo-residual disease. A total of 191 patients had PD, 60 with oligo-residual disease and 131 with non-oligo-residual disease. Regarding the pattern, 44 patients (73%) with oligo-residual disease and 37 patients (28%) with non-oligo-residual disease had PD limited to the residual sites. Multivariate logistic regression analysis at 3 months from the start of EGFR-TKI treatment revealed that oligo-residual disease (P < 0.001), the lack of residual central nervous system metastases (P = 0.032), and initial treatment with osimertinib (P = 0.028) were independent predictors of PD limited to residual disease sites.

CONCLUSIONS

This study provided a rationale for LAT to all sites of residual disease in patients with oligo-residual disease during EGFR-TKI treatment.

摘要

背景

局部消融治疗（LAT）可能对接受表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（EGFR-TKI）治疗后出现寡残留疾病的 EGFR 突变型非小细胞肺癌（NSCLC）患者有益。然而，这尚未得到充分证实。本研究旨在评估在接受 EGFR-TKI 治疗后，残留疾病部位局限的进展性疾病（PD）模式。

方法

回顾性分析了 7 年内接受 EGFR-TKI 一线治疗的晚期 EGFR 突变型 NSCLC 患者。寡残留疾病定义为 EGFR-TKI 治疗开始后 3 个月时存在 1-4 个病灶（包括原发灶）。评估了 EGFR-TKI 治疗后 PD 模式的预测因素。

结果

共纳入 207 例患者。EGFR-TKI 治疗开始后 3 个月时，66 例（32%）患者存在寡残留疾病。191 例患者出现 PD，其中 60 例为寡残留疾病，131 例为非寡残留疾病。在模式方面，44 例（73%）寡残留疾病患者和 37 例（28%）非寡残留疾病患者的 PD 局限于残留部位。从 EGFR-TKI 治疗开始 3 个月时的多变量逻辑回归分析显示，寡残留疾病（P<0.001）、无残留中枢神经系统转移（P=0.032）和初始接受奥希替尼治疗（P=0.028）是 PD 局限于残留疾病部位的独立预测因素。