表皮生长因子受体酪氨酸激酶抑制剂在根治性同步放化疗或放疗后复发的非小细胞肺癌患者中的疗效。
Efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in patients with recurrent non-small cell lung cancer after definitive concurrent chemoradiation or radiotherapy.
机构信息
Department of Oncology, Asan Medical Center University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
Department of Pulmonology and Critical Care Medicine, University of Ulsan College of Medicine, Seoul, Korea.
出版信息
J Cancer Res Clin Oncol. 2023 Jul;149(8):4243-4251. doi: 10.1007/s00432-022-04287-5. Epub 2022 Sep 5.
PURPOSE
Whether prior radiotherapy (RT) affects the response of EGFR-mutated non-small cell lung cancer (NSCLC) to EGFR tyrosine kinase inhibitor (TKI) remains elusive.
METHODS
Patients with EGFR-mutated NSCLC treated with EGFR TKIs who recurred after curative treatment at Asan Medical Center, Seoul, Korea were included. The progression-free survival (PFS) and overall survival (OS) from the initiation of EGFR TKI in patients who recurred after definitive RT were analyzed and compared to the outcomes of RT-naïve patients with advanced NSCLC treated with EGFR TKIs from previously reported prospective clinical trial results.
RESULTS
A total of 60 patients who recurred after definitive RT were included. The median age was 70 years (range, 38-88), with 24 patients (40.0%) being males. Among the 60 patients, 52 patients (86.7%) had exon 19 deletion or L858R mutation, with 49 patients (81.7%) receiving gefitinib as the first-line EGFR TKI. The median PFS and OS from the initiation of EGFR TKI were 10.4 months (95% confidence interval [CI], 7.4-13.2) and 21.3 months (95% CI, 13.4-28.8), respectively.
CONCLUSION
The EGFR TKI efficacy in EGFR-mutated patients with NSCLC who recurred after RT was comparable with that in historic controls of RT-naïve patients with advanced NSCLC treated with EGFR TKIs, indicating that RT may not affect EGFR TKI efficacy.
目的
先前接受过放疗（RT）是否会影响表皮生长因子受体（EGFR）突变型非小细胞肺癌（NSCLC）对 EGFR 酪氨酸激酶抑制剂（TKI）的反应仍不清楚。
方法
纳入在韩国首尔 Asan 医疗中心接受 EGFR TKI 治疗后治愈的 EGFR 突变型 NSCLC 患者，这些患者在复发后接受了根治性 RT。分析并比较了在根治性 RT 后复发的患者与先前报道的前瞻性临床试验中接受 EGFR TKI 治疗的晚期 NSCLC 且未接受过 RT 的患者的无进展生存期（PFS）和总生存期（OS）。
结果
共纳入 60 例在根治性 RT 后复发的患者。中位年龄为 70 岁（范围，38-88 岁），24 例（40.0%）为男性。在这 60 例患者中，52 例（86.7%）患者存在外显子 19 缺失或 L858R 突变，49 例（81.7%）患者一线接受吉非替尼作为 EGFR TKI。从开始接受 EGFR TKI 治疗的中位 PFS 和 OS 分别为 10.4 个月（95%置信区间 [CI]，7.4-13.2）和 21.3 个月（95% CI，13.4-28.8）。
结论
在 RT 后复发的 EGFR 突变型 NSCLC 患者中，EGFR TKI 的疗效与接受 EGFR TKI 治疗的晚期 NSCLC 且未接受过 RT 的历史对照患者的疗效相当，这表明 RT 可能不会影响 EGFR TKI 的疗效。
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