Ariyasu Ryo, Kakuto Sho, Miyadera Keiki, Akita Takahiro, Kiritani Ayu, Tsugitomi Ryosuke, Amino Yoshiaki, Uchibori Ken, Kitazono Satoru, Yanagitani Noriko, Nishio Makoto
Department of Thoracic Medical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
JTO Clin Res Rep. 2023 May 4;4(6):100524. doi: 10.1016/j.jtocrr.2023.100524. eCollection 2023 Jun.
Only a few reports have determined whether recently advanced anticancer drugs, particularly next-generation tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), prolong the survival of patients with NSCLC in the real world.
To evaluate the association between recently advanced drugs and patient survival, survival data of 2078 patients with stage IV NSCLC from 1995 to 2022 were analyzed in the present study. The patients were classified into the following six groups in terms of the date of diagnosis: period A, 1995 to 1999; period B, 2000 to 2004; period C, 2005 to 2009; period D, 2010 to 2014; period E, 2015 to 2019; and period F, 2000 to 2022. They were further grouped in terms of mutation and fusion.
The median overall survival (mOS) times were 8.9, 11.0, 13.6, 17.9, and 25.2 months in periods A to E, respectively, and the mOS time was not reached in period F. This time was significantly longer in period E than in period D (25.2 versus 17.9 mo, < 0.005). Moreover, the mOS times of patients with mutation, those with fusion, and those without both alterations were significantly longer in period E than in period D (46.0 versus 32.0 mo, < 0.005; not reached versus 36.2 mo, = 0.018; 14.6 versus 11.7 mo, < 0.005). The history of treatment with next-generation TKIs and ICIs was found to be associated with overall survival.
The survival of patients with NSCLC was improved from period D to period E, regardless of the presence of driver gene alteration. We found that next-generation TKIs and ICIs may be associated with improvements in overall survival.
仅有少数报告确定了近期上市的抗癌药物，特别是新一代酪氨酸激酶抑制剂（TKIs）和免疫检查点抑制剂（ICIs），在现实世界中是否能延长非小细胞肺癌（NSCLC）患者的生存期。
为评估近期上市药物与患者生存期之间的关联，本研究分析了1995年至2022年期间2078例IV期NSCLC患者的生存数据。根据诊断日期，将患者分为以下六组：A期，1995年至1999年；B期，2000年至2004年；C期，2005年至2009年；D期，2010年至2014年；E期，2015年至 2019年；F期，2020年至2022年。再根据突变和融合情况进一步分组。
A期至E期的中位总生存期（mOS）分别为8.9、11.0、13.6、17.9和25.2个月，F期的mOS未达到。E期的这一生存期明显长于D期（25.2个月对17.9个月，<0.005）。此外，E期有某突变的患者、有某融合的患者以及两者均无改变的患者的mOS明显长于D期（46.0个月对32.0个月，<0.005；未达到对36.2个月，P = 0.018；14.6个月对11.7个月，<0.005）。发现使用新一代TKIs和ICIs的治疗史与总生存期相关。
无论驱动基因改变情况如何，NSCLC患者的生存期从D期到E期有所改善。我们发现新一代TKIs和ICIs可能与总生存期的改善有关。
