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奥莫替尼在EGFR突变型晚期非小细胞肺癌真实世界治疗中的临床疗效与安全性分析

Clinical efficacy and safety analysis of aumolertinib in real-world treatment of EGFR-mutated advanced non-small-cell lung cancer.

作者信息

Zhang Xiaojuan, Zhang Mina, Du Xinyang, Zhang Guowei, Niu Yuanyuan, Wei Chunhua, Guo Lanwei, Shi Chao, Liu Hangfan, Wang Huijuan

机构信息

The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Shanghai, China.

Medical Oncology Scientific Group of the Central Medical Department, Jiangsu Hansoh, Pharmaceutical Group Co., Ltd., Shanghai, China.

出版信息

Front Pharmacol. 2024 Apr 9;15:1331138. doi: 10.3389/fphar.2024.1331138. eCollection 2024.

Abstract

This study aims to determine the efficacy and safety profile of aumolertinib in the real-word treatment setting for advanced non-small-cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) mutations. We retrospectively analyzed the clinical data of 173 EGFR-mutated advanced NSCLC patients who received aumolertinib treatment at Henan Cancer Hospital from April 2020 to December 2022. Progression-free survival (PFS) and overall survival (OS) were evaluated using Kaplan-Meier survival curves, while a Cox regression model was used for multifactorial analysis and prognostic factor assessment. Among patients administered first-line aumolertinib (n = 77), the objective remission rate (ORR) of 77.92% was observed, along with a disease control rate (DCR) of 100%. The median progression-free survival (mPFS) was 24.97 months, which did not reach the median overall survival (mOS). The patients treated with aumolertinib after progression on prior EGFR-tyrosine kinase inhibitor (TKI) therapy (n = 96) exhibited an ORR of 46.88%, a DCR of 89.58%, an mPFS of 15.17 months, and an mOS of 21.27 months. First-line treatment multivariate Cox regression analysis demonstrated a statistically significant impact of elevated creatine kinase on PFS ( = 0.016) and a similar significant influence of co-mutation on OS ( = 0.034). Furthermore, subsequent-line treatment multivariate Cox regression analysis showed a statistically significant impact of elevated creatine kinase on median PFS ( = 0.026) and a significant effect on the number of metastatic organs ( = 0.017), co-mutation ( = 0.035), and elevated creatine kinase ( = 0.014) on median OS. Aumolertinib has shown clinical significance and can safely be used in the real-world setting for patients with EGFR mutation-positive NSCLC.

摘要

本研究旨在确定奥莫替尼在携带表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌(NSCLC)患者的真实世界治疗环境中的疗效和安全性。我们回顾性分析了2020年4月至2022年12月在河南省肿瘤医院接受奥莫替尼治疗的173例EGFR突变晚期NSCLC患者的临床资料。采用Kaplan-Meier生存曲线评估无进展生存期(PFS)和总生存期(OS),同时使用Cox回归模型进行多因素分析和预后因素评估。在接受一线奥莫替尼治疗的患者(n = 77)中,观察到客观缓解率(ORR)为77.92%,疾病控制率(DCR)为100%。中位无进展生存期(mPFS)为24.97个月,未达到中位总生存期(mOS)。在先前的EGFR酪氨酸激酶抑制剂(TKI)治疗进展后接受奥莫替尼治疗的患者(n = 96)中,ORR为46.88%,DCR为89.58%,mPFS为15.17个月,mOS为21.27个月。一线治疗多因素Cox回归分析显示,肌酸激酶升高对PFS有统计学显著影响(= 0.016),共突变对OS有类似的显著影响(= 0.034)。此外,二线治疗多因素Cox回归分析显示,肌酸激酶升高对中位PFS有统计学显著影响(= 0.026),对转移器官数量(= 0.017)、共突变(= 0.035)和肌酸激酶升高(= 0.014)对中位OS有显著影响。奥莫替尼已显示出临床意义,可安全地用于EGFR突变阳性NSCLC患者的真实世界治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f2d/11036126/690c3545dbce/fphar-15-1331138-g001.jpg

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