Gibson Amanda J W, Pabani Aliyah, Dean Michelle L, Martos Guillermo, Cheung Winson Y, Navani Vishal
Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Medical Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada.
JTO Clin Res Rep. 2023 Jan 10;4(3):100460. doi: 10.1016/j.jtocrr.2022.100460. eCollection 2023 Mar.
mutations (present in 2%-3% of NSCLC) are a known oncogenic driver and emerging therapeutic target. There is a scarcity of real-world data describing the clinical characteristics, treatment patterns, and effectiveness of targeted -inhibiting and immune checkpoint inhibitor (ICI)-based systemic therapies, yet this is required for appropriate treatment decisions that optimize patient outcome.
Demographic, clinical, treatment, and outcome data of patients with mutation-positive NSCLC diagnosed between 2018 and 2022 were identified from the Glans-Look Lung Cancer Research database and included in this analysis.
A total of 53 mutation-positive patients were identified (V600E, n = 35; non-V600E, n = 18). Furthermore, 46 patients (87%) were diagnosed with metastatic disease, of whom 61% were treated with systemic anticancer therapy, which significantly improved overall survival (34.1 versus 2.2 mo, = 0.01). ICI-based regimens were found to have effectiveness in the first-line setting for both V600E and non-V600E cohorts (objective response rate: 38%-43%; real-world calculations of median progression-free survival: 10.5-10.8 mo, respectively). Dual-targeted / inhibition was also found to have effectiveness in the first-line setting for V600E patients (objective response rate: 33%, real-world calculations of median progression-free survival: 15.2 mo).
This study of real-world patients with mutations confirms the importance of effective systemic therapies. Both dual-targeted / inhibition and ICI-based regimens have evidence of benefit in this population revealing that real-world populations can experience similar clinical response and outcome to clinical trial cohorts on these treatment regimens. Future studies to clarify the role of co-mutations on response to both dual-targeted / inhibition and ICI-based regimens may be important to treatment selection and optimization of patient outcome.
突变（存在于2%-3%的非小细胞肺癌中）是一种已知的致癌驱动因素和新兴的治疗靶点。目前缺乏描述基于靶向抑制和免疫检查点抑制剂（ICI）的全身治疗的临床特征、治疗模式和有效性的真实世界数据，但这对于做出优化患者预后的恰当治疗决策是必需的。
从Glans-Look肺癌研究数据库中识别出2018年至2022年间诊断为突变阳性非小细胞肺癌患者的人口统计学、临床、治疗和结局数据，并纳入本分析。
共识别出53例突变阳性患者（V600E，n = 35；非V600E，n = 18）。此外，46例患者（87%）被诊断为转移性疾病，其中61%接受了全身抗癌治疗，这显著改善了总生存期（34.1个月对2.2个月，P = 0.01）。发现基于ICI的方案在V600E和非V600E队列的一线治疗中均有效（客观缓解率：38%-43%；无进展生存期的真实世界计算值：分别为10.5-10.8个月）。还发现双靶点/抑制在V600E患者的一线治疗中也有效（客观缓解率：33%，无进展生存期的真实世界计算值：15.2个月）。
这项对真实世界中突变患者的研究证实了有效全身治疗的重要性。双靶点/抑制和基于ICI的方案在该人群中均有获益证据，表明真实世界人群在这些治疗方案上可经历与临床试验队列相似的临床反应和结局。未来阐明共突变对双靶点/抑制和基于ICI方案反应的作用的研究可能对治疗选择和患者预后优化很重要。
