Onoi Keisuke, Yamada Tadaaki, Morimoto Kenji, Kawachi Hayato, Tsutsumi Rei, Takeda Takayuki, Okada Asuka, Tamiya Nobuyo, Chihara Yusuke, Shiotsu Shinsuke, Takemura Yoshizumi, Yamada Takahiro, Hasegawa Isao, Katayama Yuki, Iwasaku Masahiro, Tokuda Shinsaku, Takayama Koichi
Department of Pulmonary Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465, Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan.
Department of Respiratory Medicine, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan.
Target Oncol. 2024 May;19(3):411-421. doi: 10.1007/s11523-024-01045-0. Epub 2024 Mar 11.
Combination therapy with docetaxel (DTX) and ramucirumab (RAM) has been used as a second-line treatment for advanced or recurrent lung cancer. However, there is insufficient evidence regarding the safety of angiogenesis inhibitors in older patients.
This multicenter retrospective study aimed to investigate the efficacy and safety of second-line treatment regimens in older patients with advanced or recurrent non-small cell lung cancer (NSCLC).
We retrospectively analyzed 145 patients aged ≥ 70 years with advanced or recurrent NSCLC treated with second-line chemotherapy after platinum-based therapy between April 1, 2016, and March 31, 2021. Patients were subdivided into the DTX + RAM (n = 38) and single-agent (n = 107) groups.
The median time to treatment failure was 6.3 months (95% confidence interval [CI] 3.6-9.6) in the DTX + RAM group and 2.3 months (95% CI 1.7-3.0) in the single-agent group (p < 0.01). The median overall survival was 15.9 months (95% CI 12.3-Not Achieved) in the DTX + RAM group and 9.4 months (95% CI 6.9-15.1) in the single-agent group (p = 0.01). Grade ≥ 3 adverse events frequency was not significantly different between the two groups, except for edema. Patients in the DTX + RAM group who did not discontinue treatment owing to adverse events exhibited the most favorable prognosis.
These findings suggest that the DTX + RAM combination is an effective second-line therapy for older patients with advanced or recurrent NSCLC, offering favorable efficacy without treatment discontinuation owing to adverse events.
多西他赛（DTX）与雷莫西尤单抗（RAM）联合治疗已被用作晚期或复发性肺癌的二线治疗方案。然而，关于血管生成抑制剂在老年患者中的安全性证据不足。
这项多中心回顾性研究旨在探讨晚期或复发性非小细胞肺癌（NSCLC）老年患者二线治疗方案的疗效和安全性。
我们回顾性分析了2016年4月1日至2021年3月31日期间接受铂类治疗后接受二线化疗的145例年龄≥70岁的晚期或复发性NSCLC患者。患者被分为DTX+RAM组（n = 38）和单药组（n = 107）。
DTX+RAM组治疗失败的中位时间为6.3个月（95%置信区间[CI] 3.6 - 9.6），单药组为2.3个月（95% CI 1.7 - 3.0）（p < 0.01）。DTX+RAM组的中位总生存期为15.9个月（95% CI 12.3 - 未达到），单药组为9.4个月（95% CI 6.9 - 15.1）（p = 0.01）。除水肿外，两组≥3级不良事件的发生率无显著差异。DTX+RAM组中未因不良事件而停药的患者预后最佳。
这些结果表明，DTX+RAM联合治疗是晚期或复发性NSCLC老年患者有效的二线治疗方案，疗效良好且不会因不良事件而停药。
