Department of Medical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3# East Qinchun Road, Hangzhou, 310016, Zhejiang, China.
Laboratory of Cancer Biology, Key Laboratory of Biotherapy of Zhejiang Province, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Sci Rep. 2022 Aug 26;12(1):14624. doi: 10.1038/s41598-022-18889-z.
Patients with epidermal growth factor receptor (EGFR) exon 21 L858R substitution benefit less from standard EGFR tyrosine kinase inhibitor (TKI) treatment, and whether anti-angiogenic therapy was beneficial to the EGFR L858R subpopulation was inconclusive. A retrospective study was conducted to investigate the survival benefit and the target characteristics of the anti-angiogenic agent in the EGFR L858R patients in our center, comparing those treated with or without anti-angiogenic therapy (cohort A and cohort B). At the median follow-up time of 31.0 months vs 32.7 months (cohort A vs. B) respectively, Cohort A (n = 58) had a significantly prolonged median OS compared to Cohort B (n = 101) (60.0 months vs.37.0 months, HR 0.51, p = 0.016). Anti-angiogenic therapy significantly prolonged the OS in patients with liver metastases (NA vs.26.0 months, HR 0.17, p = 0.023) comparing to patients without liver metastases (60.0 months vs.37.0 months, HR 0.63, p = 0.129). For brain metastatic patients, anti-angiogenic treatment tended to improve median OS with (65.0 months vs.35.0 months, HR 0.29, p = 0.068) or without brain radiotherapy (73.0 months vs.29.0 months, HR 0.24, p = 0.171). The grade 3 or more adverse events were manageable and consistent with previous studies. Patients with EGFR L858R mutation treated with anti-angiogenic therapy in their course of treatment had a significantly prolonged OS compared to those who had never received an anti-angiogenic agent. Patients with liver metastases might benefit more from anti-angiogenic therapy than those without.
患者表皮生长因子受体（EGFR）外显子 21 L858R 取代获益较少从标准的 EGFR 酪氨酸激酶抑制剂（TKI）治疗，和抗血管生成治疗是否有利于 EGFR L858R 亚群尚无定论。一项回顾性研究旨在探讨我们中心的 EGFR L858R 患者的生存获益和抗血管生成药物的靶向特征，比较那些接受或不接受抗血管生成治疗（队列 A 和队列 B）。在中位随访时间 31.0 个月与 32.7 个月（队列 A 与 B）分别，队列 A（n=58）与队列 B（n=101）相比，中位 OS 显著延长（60.0 个月与 37.0 个月，HR 0.51，p=0.016）。抗血管生成治疗显著延长肝转移患者的 OS（NA 与 26.0 个月，HR 0.17，p=0.023）与无肝转移患者（60.0 个月与 37.0 个月，HR 0.63，p=0.129）。对于脑转移患者，抗血管生成治疗倾向于改善中位 OS（65.0 个月与 35.0 个月，HR 0.29，p=0.068）或无脑放疗（73.0 个月与 29.0 个月，HR 0.24，p=0.171）。3 级或以上不良事件是可管理的，与以前的研究一致。在治疗过程中接受抗血管生成治疗的 EGFR L858R 突变患者的 OS 明显长于从未接受过抗血管生成药物的患者。肝转移患者可能比无肝转移患者更受益于抗血管生成治疗。
