Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute affiliated of Shandong University, Jinan, Shandong, China.
Cancer Med. 2023 Mar;12(5):5352-5363. doi: 10.1002/cam4.5356. Epub 2022 Oct 21.
No definite conclusion has yet to be reached for the first-line treatment combined with chemotherapy for advanced adenocarcinoma NSCLC patients with negative driver genes. This study sought to compare the clinical outcomes of Beva+ChT and IO+ChT as first-line treatment for this population and investigated whether the statuses of BM, PD-L1 expression, and KRAS and TP53 mutations could influence the results.
The clinical data of patients with adenocarcinoma NSCLC who received first-line therapy were retrospectively collected and the patients were assigned to the IO+ChT and Beva+ChT groups. The disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were evaluated between the two groups. The survival effects of BM, PD-L1 expression, and KRAS and TP53 mutations were also evaluated.
From April 2018 to October 2020, a total of 105 patients with first-line therapy were included in our analysis; 54 (51.4%) patients were included in the IO+ChT group and 51 (48.6%) patients were included in the Beva+ChT group. The results showed that OS (NR vs. 18.3 m, p = 0.011) and PFS (14.9 m vs. 6.3 m, p < 0.001) were superior in patients in the IO+ChT group than in patients in the Beva+ChT group. Further analysis revealed that the OS (median OS: NR vs. 14.7 months, p = 0.039) and PFS (median PFS: 18.5 vs. 5.5 months, p < 0.001) advantages of the IO+ChT group were also seen in the PD-L1 > 1% subgroup but were not seen in the PD-L1 < 1%, BM or KRAS mutation subgroups.
ICIs combined with ChT improved clinical outcomes over Beva combined with ChT as first-line therapy for adenocarcinoma patients without driver gene alterations, especially in patients with PD-L1 ≥ 1%.
对于携带阴性驱动基因的晚期非小细胞肺癌（NSCLC）腺癌患者，联合化疗的一线治疗方案尚无明确结论。本研究旨在比较贝伐珠单抗联合化疗（Beva+ChT）和免疫检查点抑制剂（IO）联合化疗（IO+ChT）作为此类患者一线治疗的临床疗效，并探讨骨髓（BM）状态、程序性死亡配体 1（PD-L1）表达、KRAS 和 TP53 突变是否会影响结果。
回顾性收集接受一线治疗的腺癌 NSCLC 患者的临床资料，并将患者分为 IO+ChT 组和 Beva+ChT 组。评估两组间疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）。还评估了 BM、PD-L1 表达、KRAS 和 TP53 突变对生存的影响。
2018 年 4 月至 2020 年 10 月，共纳入 105 例接受一线治疗的患者，其中 IO+ChT 组 54 例（51.4%），Beva+ChT 组 51 例（48.6%）。结果显示，IO+ChT 组患者的 OS（NR 与 18.3 m，p=0.011）和 PFS（14.9 m 与 6.3 m，p<0.001）均优于 Beva+ChT 组。进一步分析显示，在 PD-L1>1%亚组中，IO+ChT 组的 OS（中位 OS：NR 与 14.7 个月，p=0.039）和 PFS（中位 PFS：18.5 与 5.5 个月，p<0.001）也具有优势，但在 PD-L1<1%、BM 或 KRAS 突变亚组中则无优势。
对于无驱动基因改变的腺癌患者，与贝伐珠单抗联合化疗相比，ICI 联合化疗作为一线治疗可改善临床结局，特别是在 PD-L1≥1%的患者中。
Zotero 插件
