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吉非替尼联合安罗替尼治疗表皮生长因子受体(EGFR)阳性晚期非小细胞肺癌患者的疗效与安全性:一项回顾性探索性研究

Efficacy and Safety of Gefitinib Plus Anlotinib for Patients with EGFR Positive Advanced Non-Small-Cell Lung Cancer: A Retrospective Exploratory Study.

作者信息

Hu Wen-Xia, Peng Jing-Cui, Wang Yun, Jin Hao, Geng Nan

机构信息

Department of Respiratory Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang, 050012, People's Republic of China.

出版信息

Int J Gen Med. 2022 Apr 27;15:4453-4464. doi: 10.2147/IJGM.S350771. eCollection 2022.

Abstract

OBJECTIVE

This study was to investigate the efficacy and safety of gefitinib plus anlotinib for patients with EGFR positive advanced non-small cell lung cancer (NSCLC) in a first-line setting.

METHODS

A total of 36 patients with previously-untreated EGFR positive advanced NSCLC were included in this study retrospectively. All patients were administered with gefitinib plus anlotinib combination therapy. The efficacy of the patients was evaluated with the change of target lesion using imaging evidence according to RECIST 1.1 criteria and all the patients were followed up regularly. Adverse reactions were collected and documented during the combination administration. Univariate analysis according to the baseline characteristic subgroup was implemented using Log rank test and multivariate analysis was adjusted by Cox regression analysis.

RESULTS

All the 36 patients included in our study were available for efficacy and safety analysis. Best overall response of the patients during gefitinib plus anlotinib administration suggested that partial response was observed in 30 patients, stable disease was noted in five patients, and progressive disease was found in one patient, which yielded an objective response rate (ORR) of 83.3% (95% CI=67.2-93.6%) and a disease control rate (DCR) of 97.2% (95% CI=85.5-99.9%). Prognostic data indicated that the median progression-free survival (PFS) of the 36 patients with NSCLC was 15.2 months (95% CI=8.15-22.26). Furthermore, the median overall survival (OS) of the 36 patients was 35.9 months (95% CI=22.77-49.03). Additionally, the most common adverse reactions of the patients with NSCLC were diarrhea (63.9%), fatigue (58.3%), hypertension (50.0%), rash (44.4%), and nausea and vomiting (41.7%). Furthermore, ECOG performance status was associated with PFS of gefitinib plus anlotinib combination therapy in baseline characteristic subgroup analysis.

CONCLUSION

Gefitinib plus anlotinib regimen demonstrated encouraging efficacy and an acceptable safety profile for patients with previously untreated EGFR positive NSCLC preliminarily. The conclusion should be validated in prospective clinical trials subsequently.

摘要

目的

本研究旨在探讨吉非替尼联合安罗替尼一线治疗表皮生长因子受体(EGFR)阳性的晚期非小细胞肺癌(NSCLC)患者的疗效和安全性。

方法

本研究回顾性纳入36例既往未接受过治疗的EGFR阳性晚期NSCLC患者。所有患者均接受吉非替尼联合安罗替尼的联合治疗。根据实体瘤疗效评价标准(RECIST)1.1,通过影像学证据观察靶病灶的变化来评估患者的疗效,并对所有患者进行定期随访。在联合给药期间收集并记录不良反应。采用Log rank检验对基线特征亚组进行单因素分析,并通过Cox回归分析进行多因素分析。

结果

本研究纳入的36例患者均进行了疗效和安全性分析。吉非替尼联合安罗替尼治疗期间患者的最佳总体反应显示,30例患者观察到部分缓解,5例患者病情稳定,1例患者疾病进展,客观缓解率(ORR)为83.3%(95%CI=67.2-93.6%),疾病控制率(DCR)为97.2%(95%CI=85.5-99.9%)。预后数据表明,36例NSCLC患者的中位无进展生存期(PFS)为15.2个月(95%CI=8.15-22.26)。此外,36例患者的中位总生存期(OS)为35.9个月(95%CI=22.77-49.03)。此外,NSCLC患者最常见的不良反应为腹泻(63.9%)、疲劳(58.3%)、高血压(50.0%)、皮疹(44.4%)以及恶心和呕吐(41.7%)。此外,在基线特征亚组分析中,东部肿瘤协作组(ECOG)体能状态与吉非替尼联合安罗替尼联合治疗的PFS相关。

结论

吉非替尼联合安罗替尼方案初步显示出令人鼓舞的疗效,且对于既往未接受过治疗的EGFR阳性NSCLC患者具有可接受的安全性。该结论随后应在前瞻性临床试验中得到验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4d8/9059207/322117d8a27a/IJGM-15-4453-g0001.jpg

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