Tsui David Chun Cheong, Holt Douglas E, Patil Tejas, Staley Alyse, Gao Dexiang, Kavanagh Brian D, Schenk Erin L, Rusthoven Chad G, Camidge D Ross
Division of Medical Oncology, Department of Medicine, University of Colorado Cancer Center, Denver, Colorado.
Department of Radiation Oncology, University of Colorado Anschutz Medical Campus, Denver, Colorado.
Adv Radiat Oncol. 2024 Apr 14;9(7):101516. doi: 10.1016/j.adro.2024.101516. eCollection 2024 Jul.
We first described the role of local radiation therapy (LT) for oligoprogressive disease (OPD) on targeted therapy in 2012. Here, we present an updated and larger data set and extend the analysis beyond EGFR and ALK.
A retrospective review of patients with metastatic NSCLC harboring V600E mutations, or rearrangements, who had OPD on respective tyrosine-kinase inhibitor (TKI) and treated with LT was performed. OPD was defined as disease progression on therapy in ≤5 sites. PFS1 (progression-free survival 1) was defined as time from initiation of TKI-containing regimen to the first course of LT for OPD. Subsequent PFS times (eg, PFS2, PFS3) were defined as time from prior LT to subsequent LT, switch of systemic therapy, death, or loss to follow-up, whichever occurred first. Extended-PFS was defined as time from the first day of the first LT course to the day of change in systemic therapy, death, or loss to follow-up, whichever came first.
Eighty-nine patients were identified. In 75.4% of the LT courses, a single lesion was treated. Median PFS1 was 10.2 months (95% CI, 8.7-13.1) and median Extended-PFS was 6.7 months (95% CI, 4.9-8.3). Extended-PFS was similar across different oncogenic drivers; 51.4% of patients who underwent LT to a single site had only 1 site on next disease progression.
LT is effective in prolonging treatment duration on TKI in oncogene-addicted NSCLC across multiple oncogenes.
2012年我们首次描述了局部放射治疗（LT）对寡进展性疾病（OPD）在靶向治疗中的作用。在此，我们展示一个更新且更大的数据集，并将分析扩展至表皮生长因子受体（EGFR）和间变性淋巴瘤激酶（ALK）之外。
对携带V600E突变或重排、在各自的酪氨酸激酶抑制剂（TKI）治疗中出现OPD并接受LT治疗的转移性非小细胞肺癌（NSCLC）患者进行回顾性研究。OPD定义为治疗中≤5个部位出现疾病进展。无进展生存期1（PFS1）定义为从含TKI方案开始至针对OPD的首次LT疗程的时间。后续的无进展生存期（如PFS2、PFS3）定义为从前一次LT至后续LT、全身治疗转换、死亡或失访（以先发生者为准）的时间。延长无进展生存期定义为从首个LT疗程的第一天至全身治疗改变、死亡或失访（以先发生者为准）的时间。
共纳入89例患者。在75.4%的LT疗程中，仅治疗单个病灶。中位PFS1为10.2个月（95%可信区间[CI]，8.7 - 13.1），中位延长无进展生存期为6.7个月（95%CI，4.9 - 8.3）。不同致癌驱动因素的延长无进展生存期相似；接受单个部位LT治疗的患者中，51.4%在下一次疾病进展时仅有1个部位出现病变。
LT可有效延长多种致癌基因驱动的成瘾性NSCLC患者TKI治疗的持续时间。
