Department of Thoracic Medical Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
Department of Radiation Oncology, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, Fujian Province, China.
Anticancer Agents Med Chem. 2023;23(19):2095-2101. doi: 10.2174/1871520623666230803142758.
Treatment options for advanced non-small-cell lung cancer (NSCLC) after osimertinib failure are limited, and osimertinib continuation is recommended for selected patients. Metronomic oral vinorelbine is an effective treatment with less toxicity for advanced NSCLC.
The objective of the study was to investigate the effects of osimertinib plus metronomic oral vinorelbine on epidermal growth factor receptor (EGFR)-mutant advanced NSCLC beyond limited progression on osimertinib.
We have reviewed the medical records of 28 patients with EGFR-mutant advanced NSCLC who had received osimertinib continuation plus metronomic oral vinorelbine beyond limited progression on osimertinib. We also evaluated the clinicopathological characteristics of enrolled patients, as well as the efficacy and toxicity of the treatment.
After a median follow-up period of 14.1 months, 57.1% (16/28) of cases showed NSCLC progression. The median progression-free survival (PFS) period under osimertinib plus metronomic oral vinorelbine was 9.4 months (95% confidence interval, 1.562-17.238 months), with a disease control rate of 89.3% and objective response rate of 17.9%. PFS did not differ between patients who had previously received osimertinib as first- (n = 16) and second-line (n = 12) therapy (median, 11.4 and 4.7 months, P = 0.391). In addition, the median PFS duration did not differ according to the efficacy (PFS2 ≥ 6 months vs. <6 months) of previous osimertinib monotherapy (median, 5.8 and 9.4 months, P = 0.677).
Osimertinib continuation in conjunction with metronomic oral vinorelbine may enable overcoming TKI resistance and prolong the survival of patients with EGFR-mutant advanced NSCLC beyond limited progression on osimertinib treatment.
奥希替尼治疗失败后的晚期非小细胞肺癌（NSCLC）治疗选择有限，建议为选定的患者继续使用奥希替尼。节拍口服长春瑞滨是一种对晚期 NSCLC 有效且毒性较小的治疗方法。
本研究旨在探讨奥希替尼联合节拍口服长春瑞滨对奥希替尼治疗后出现有限进展的 EGFR 突变晚期 NSCLC 的疗效。
我们回顾了 28 例接受奥希替尼继续治疗联合节拍口服长春瑞滨治疗的 EGFR 突变晚期 NSCLC 患者的病历。我们还评估了入组患者的临床病理特征，以及治疗的疗效和毒性。
中位随访 14.1 个月后，57.1%（16/28）的病例出现 NSCLC 进展。奥希替尼联合节拍口服长春瑞滨治疗的中位无进展生存期（PFS）为 9.4 个月（95%置信区间，1.562-17.238 个月），疾病控制率为 89.3%，客观缓解率为 17.9%。先前接受奥希替尼一线（n=16）和二线（n=12）治疗的患者的 PFS 无差异（中位，11.4 和 4.7 个月，P=0.391）。此外，先前奥希替尼单药治疗疗效（PFS2≥6 个月与<6 个月）的中位 PFS 时间也无差异（中位，5.8 和 9.4 个月，P=0.677）。
奥希替尼联合节拍口服长春瑞滨可能有助于克服 TKI 耐药，延长 EGFR 突变晚期 NSCLC 患者奥希替尼治疗后出现有限进展的生存时间。
