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阿美替尼和安罗替尼联合治疗方案用于第三代 EGFR-TKI 治疗期间持续发生疾病进展的晚期非小细胞肺癌患者的疗效:一项回顾性研究。

The efficacy of almonertinib and anlotinib combination therapy for advanced non-small-cell lung cancer patients who continued to experience cancer progression during third-generation EGFR-TKI treatment: a retrospective study.

机构信息

Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin Clinical Research Center of Cancer, Tianjin Lung Cancer Center, Tianjin, China.

出版信息

Thorac Cancer. 2024 Aug;15(23):1757-1763. doi: 10.1111/1759-7714.15399. Epub 2024 Jul 10.

Abstract

BACKGROUND

Epidermal growth factor receptor (EGFR) mutations are key drivers in a significant portion of non-small-cell lung cancer (NSCLC) patients. While third-generation EGFR-tyrosine kinase inhibitors (TKIs) such as osimertinib have demonstrated efficacy, the management of patients who continue to experience disease progression during treatment remains challenging. The emergence of drug resistance, including the development of secondary mutations, necessitates exploration of alternative treatment strategies. This study aims to evaluate and observe the efficacy and safety of almonertinib combined with anlotinib in patients after cancer progression during third-generation EGFR-TKI therapy.

METHODS

In this retrospective analysis, we included EGFR-mutated NSCLC patients who were resistant to third-generation EGFR-TKIs. All patients were treated with almonertinib combined with anlotinib. The clinical characteristics, treatment history, clinical benefits, and adverse events of these patients were retrospectively collected.

RESULTS

A total of 16 eligible patients were included in the analysis. The results revealed that combination therapy with almonertinib and anlotinib was effective in this patient cohort. The overall response rate was 25% and the disease control rate was 93.75%. The 6 and 12 months of PFS rates were 92.9% (95% confidence interval [CI] 80.3%, 100.0%) and 84.4% (95% CI 66.6%, 100.0%), respectively. Moreover, this combination therapy was generally well-tolerated, with manageable adverse events.

CONCLUSION

Our retrospective analysis suggests that almonertinib and anlotinib combination therapy may represent a viable option for EGFR-mutated NSCLC patients who have progressed on third-generation EGFR-TKIs, especially for those with posterior lines and no standard treatment options. Further investigation and larger clinical trials are warranted to validate these observations and refine treatment guidelines.

摘要

背景

表皮生长因子受体(EGFR)突变是部分非小细胞肺癌(NSCLC)患者的关键驱动因素。虽然第三代 EGFR 酪氨酸激酶抑制剂(TKI)如奥希替尼已显示出疗效,但在治疗过程中继续出现疾病进展的患者的管理仍然具有挑战性。药物耐药性的出现,包括继发突变的发展,需要探索替代治疗策略。本研究旨在评估和观察第三代 EGFR-TKI 治疗后癌症进展的患者中使用阿美替尼联合安罗替尼的疗效和安全性。

方法

在这项回顾性分析中,我们纳入了对第三代 EGFR-TKI 耐药的 EGFR 突变型 NSCLC 患者。所有患者均接受阿美替尼联合安罗替尼治疗。回顾性收集这些患者的临床特征、治疗史、临床获益和不良事件。

结果

共纳入 16 例符合条件的患者进行分析。结果显示,阿美替尼联合安罗替尼治疗在该患者队列中是有效的。总缓解率为 25%,疾病控制率为 93.75%。6 个月和 12 个月的无进展生存率分别为 92.9%(95%置信区间 [CI] 80.3%,100.0%)和 84.4%(95% CI 66.6%,100.0%)。此外,这种联合治疗总体上耐受性良好,不良反应可管理。

结论

我们的回顾性分析表明,阿美替尼和安罗替尼联合治疗可能是第三代 EGFR-TKI 治疗后进展的 EGFR 突变型 NSCLC 患者的一种可行选择,特别是对于那些有后线治疗且无标准治疗选择的患者。需要进一步的研究和更大的临床试验来验证这些观察结果并完善治疗指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/05d0/11320088/e30c62fa7cdf/TCA-15-1757-g002.jpg

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