根治性放化疗和度伐利尤单抗巩固治疗后进展的局部晚期非小细胞肺癌的后续治疗：一项多中心回顾性分析（TOPGAN 2021-02）。
Subsequent treatment for locally advanced non-small-cell lung cancer that progressed after definitive chemoradiotherapy and consolidation therapy with durvalumab: a multicenter retrospective analysis (TOPGAN 2021-02).
机构信息
Division of Respiratory Disease, Department of Internal Medicine, The Jikei University Daisan Hospital, Tokyo, Japan.
Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
出版信息
Cancer Chemother Pharmacol. 2023 Jul;92(1):29-37. doi: 10.1007/s00280-023-04547-2. Epub 2023 May 27.
PURPOSE
For patients with locally advanced non-small-cell lung cancer (LA-NSCLC) that progressed after definitive chemoradiotherapy (CRT) and durvalumab consolidation therapy, no subsequent standard treatment exists. The type of treatment selected for each timing of disease progression and its efficacy have not been investigated.
METHODS
We retrospectively enrolled patients with LA-NSCLC or inoperable NSCLC that progressed after definitive CRT and durvalumab consolidation therapy at 15 Japanese institutions. Patients were classified into the following: Early Discontinuation group (disease progression within 6 months after durvalumab initiation), Late Discontinuation group (disease progression from 7 to 12 months after durvalumab initiation), and Accomplishment group (disease progression from 12 months after durvalumab initiation).
RESULTS
Altogether, 127 patients were analyzed, including 50 (39.4%), 42 (33.1%) and 35 (27.5%) patients from the Early Discontinuation, Late Discontinuation, and Accomplishment groups, respectively. Subsequent treatments were Platinum plus immune checkpoint inhibitors (ICI) in 18 (14.2%), ICI in 7 (5.5%), Platinum in 59 (46.4%), Non-Platinum in 35 (27.6%), and tyrosine kinase inhibitor in 8 (6.3%) patients. In the Early Discontinuation, Late Discontinuation, and Accomplishment groups, 4 (8.0%), 7 (16.7%), and 7 (20.0%) patients were receiving Platinum plus ICI; 21 (42.0%), 22 (52.4%), and 16 (45.7%) were receiving Platinum, and 20 (40.0%), 8 (19.0%), and 7 (20.0%) were receiving Non-Platinum, respectively. No significant difference in progression-free survival was observed in the timing of disease progression.
CONCLUSION
In patients with LA-NSCLC hat progressed after definitive CRT and durvalumab consolidation therapy, subsequent treatment may change depending on the timing of disease progression.
目的
对于接受根治性放化疗（CRT）和度伐利尤单抗巩固治疗后局部晚期非小细胞肺癌（LA-NSCLC）进展的患者，目前尚无后续标准治疗。尚未研究疾病进展不同时间点选择的治疗类型及其疗效。
方法
我们回顾性纳入了在日本 15 家机构接受根治性 CRT 和度伐利尤单抗巩固治疗后进展的 LA-NSCLC 或不可切除 NSCLC 的患者。患者被分为以下三组：早期停药组（度伐利尤单抗治疗开始后 6 个月内疾病进展）、晚期停药组（度伐利尤单抗治疗开始后 7-12 个月内疾病进展）和完成组（度伐利尤单抗治疗开始后 12 个月后疾病进展）。
结果
共分析了 127 例患者，其中早期停药组、晚期停药组和完成组分别有 50 例（39.4%）、42 例（33.1%）和 35 例（27.5%）患者。后续治疗包括铂类加免疫检查点抑制剂（ICI）18 例（14.2%）、ICI 治疗 7 例（5.5%）、铂类治疗 59 例（46.4%）、非铂类治疗 35 例（27.6%）和酪氨酸激酶抑制剂治疗 8 例（6.3%）。在早期停药组、晚期停药组和完成组中，分别有 4 例（8.0%）、7 例（16.7%）和 7 例（20.0%）患者接受铂类加 ICI 治疗；21 例（42.0%）、22 例（52.4%）和 16 例（45.7%）患者接受铂类治疗；20 例（40.0%）、8 例（19.0%）和 7 例（20.0%）患者接受非铂类治疗。疾病进展时间不同，无进展生存期无显著差异。
结论
对于接受根治性 CRT 和度伐利尤单抗巩固治疗后进展的 LA-NSCLC 患者，后续治疗可能会根据疾病进展的时间而改变。
Zotero 插件