Department of Respiratory Medicine, Hokkaido University Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060-8638, Japan.
Department of Respiratory Medicine, Sapporo Minami Sanjo Hospital, Sapporo, Japan.
Sci Rep. 2021 Nov 30;11(1):23140. doi: 10.1038/s41598-021-02561-z.
Osimertinib is a standard of care therapy for previously untreated epidermal growth factor receptor mutation-positive non-small cell lung cancer. However, limited data exist regarding the efficacy and safety of osimertinib as a first-line therapy for elderly patients aged 75 years or older. To assess the potential clinical benefits of osimertinib in this population, this retrospective multi-institutional observational study included 132 patients with non-small cell lung cancer (age ≥ 75 years), who received osimertinib as first-line treatment. The proportion of patients with 1-year progression-free survival was 65.8% (95% confidence interval 57.1-73.5). The median progression-free survival was 19.4 (95% confidence interval 15.9-23.9) months. The median overall survival was not reached (95% confidence interval 24.6-not reached). The frequency of pneumonitis was 17.4%, with a grade 3 or higher rate of 9.1%. More than two-thirds of treatment discontinuations due to pneumonitis occurred within 3 months of starting osimertinib, and the prognosis of patients with pneumonitis was unsatisfactory. Osimertinib is one of the effective first-line therapeutic options for patients aged 75 years or older; however, special caution should be exercised due to the potential development of pneumonitis.
奥希替尼是治疗未经治疗的表皮生长因子受体突变阳性非小细胞肺癌的标准治疗方法。然而，关于奥希替尼作为 75 岁或以上老年患者一线治疗的疗效和安全性的数据有限。为了评估奥希替尼在这一人群中的潜在临床获益，这项回顾性多机构观察性研究纳入了 132 名年龄≥75 岁的非小细胞肺癌患者，他们接受奥希替尼作为一线治疗。1 年无进展生存率的患者比例为 65.8%（95%置信区间为 57.1-73.5）。中位无进展生存期为 19.4 个月（95%置信区间为 15.9-23.9）。中位总生存期未达到（95%置信区间为 24.6-未达到）。肺炎的发生率为 17.4%，3 级或以上发生率为 9.1%。超过三分之二的因肺炎而停止治疗的发生在奥希替尼治疗开始后 3 个月内，且肺炎患者的预后不佳。奥希替尼是 75 岁或以上患者的有效一线治疗选择之一；然而，由于可能发生肺炎，应特别小心。
