Nokihara Hiroshi, Ogino Hirokazu, Mitsuhashi Atsushi, Kondo Kensuke, Ogawa Ei, Ozaki Ryohiko, Yabuki Yohei, Yoneda Hiroto, Otsuka Kenji, Nishioka Yasuhiko
Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan.
Present Address: Respiratory Medicine, Center Hospital of the National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan.
BMC Cancer. 2022 Jun 1;22(1):597. doi: 10.1186/s12885-022-09701-2.
Osimertinib is a standard first-line treatment for advanced non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. Although malignant pleural effusion (PE) is a common clinical problem in NSCLC, information about the efficacy of osimertinib in patients with PE is limited, especially regarding its efficacy in EGFR T790M-negative patients with PE remains unclear.
We retrospectively reviewed the medical records of patients with NSCLC harboring EGFR mutations who were treated with osimertinib in our institution between May 2016 and December 2020.
A total of 63 patients with EGFR mutated NSCLC were treated with osimertinib; 33 (12 with PE) had no EGFR T790M mutation, while 30 (12 with PE) had EGFR T790M mutation. In EGFR T790M-negative NSCLC, the progression-free survival (PFS) of the patients with PE was comparable to that of the patients without PE (median PFS 19.8 vs. 19.8 months, p = 0.693). In EGFR T790M- positive NSCLC, the PFS and overall survival (OS) of the patients with PE were significantly shorter than those of the patients without PE (median PFS 16.8 vs. 8.3 months, p = 0.003; median OS 44.9 vs. 14.2 months, p = 0.007). In the multivariate analysis, the presence of PE was independently associated with shorter PFS and OS in EGFR T790M-positive NSCLC patients, but not EGFR T790M-negative patients.
These data suggest the efficacy of osimertinib may differ between EGFR T790M-positive and -negative NSCLC patients with PE.
奥希替尼是携带表皮生长因子受体（EGFR）突变的晚期非小细胞肺癌（NSCLC）的标准一线治疗药物。尽管恶性胸腔积液（PE）是NSCLC常见的临床问题，但关于奥希替尼对PE患者疗效的信息有限，尤其是其对EGFR T790M阴性的PE患者的疗效仍不明确。
我们回顾性分析了2016年5月至2020年12月在我院接受奥希替尼治疗的携带EGFR突变的NSCLC患者的病历。
共有63例EGFR突变的NSCLC患者接受了奥希替尼治疗；33例（12例有PE）无EGFR T790M突变，30例（12例有PE）有EGFR T790M突变。在EGFR T790M阴性的NSCLC中，有PE的患者的无进展生存期（PFS）与无PE的患者相当（中位PFS 19.8个月对19.8个月，p = 0.693）。在EGFR T790M阳性的NSCLC中，有PE的患者的PFS和总生存期（OS）明显短于无PE的患者（中位PFS 16.8个月对8.3个月，p = 0.003；中位OS 44.9个月对14.2个月，p = 0.007）。在多变量分析中，PE的存在与EGFR T790M阳性的NSCLC患者较短的PFS和OS独立相关，但与EGFR T790M阴性的患者无关。
这些数据表明，奥希替尼对EGFR T790M阳性和阴性的NSCLC合并PE患者的疗效可能不同。
