Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
BMC Cancer. 2024 Aug 23;24(1):1043. doi: 10.1186/s12885-024-12797-3.
The present study aimed to investigate physicians' perspectives on the diagnosis and treatment decisions for patients with non-small cell lung cancer (NSCLC) harbouring epidermal growth factor receptor (EGFR) exon 20 insertion (exon20ins) mutations in a real-world setting in China using an online questionnaire.
This study was performed via the CAPTRA-Lung collaboration between December 9, 2022 and March 6, 2023. The questionnaire was distributed digitally to physicians around China and was comprised of three sections: basic characteristics of surveyed physicians, diagnosis and treatment status of NSCLC patients with the EGFR exon20ins-mutation, and physicians' perspectives on treatment options. Physicians who treat more than 10 patients with advanced NSCLC every month and who have treated patients with advanced EGFR exon20ins-mutant NSCLC in the past six months were involved in this study.
A total of 53,729 questionnaires were distributed and 390 valid ones were collected. The EGFR mutation test was performed in 80.9% and 59.9% of patients receiving first-line or second-line therapy and beyond (hereinafter "second-line")therapy, respectively. In terms of treatment options, chemotherapy plus antiangiogenic therapy was the most common treatment option (30.0% of patients in first-line settings; 25.0% of patients in second-line settings), and a certain proportion of patients received novel EGFR exon20ins-targeted agents (including tyrosine kinase inhibitors [TKIs] and bispecific antibodies) in first- or second-line settings, which accounted for 11.9% and 15.7% of all treated patients, respectively. Additionally, physicians reported the highest satisfaction score for the efficacy and safety of targeted agents. Most physicians believed that EGFR exon20ins-targeted TKIs represented the most promising treatment option (80.2% in first-line treatment and 73.3% in second-line treatment). Among several novel agents under study, sunvozertinib has received the highest recognition for efficacy and safety.
This study investigated the current diagnosis and treatment status and physicians' perspective, of patients with EGFR exon20ins-mutant NSCLC. The results highlight significant unmet clinical needs in this subgroup of patients. EGFR exon20ins-targeted TKIs were recognized as the most promising treatment regimen and may benefit more patients considering their awareness and acceptance of targeted therapy.
本研究旨在通过在线问卷，在中国真实环境中调查医生对非小细胞肺癌（NSCLC）患者携带表皮生长因子受体（EGFR）外显子 20 插入（exon20ins）突变的诊断和治疗决策的看法。
本研究由 CAPTRA-Lung 合作于 2022 年 12 月 9 日至 2023 年 3 月 6 日进行。问卷通过数字形式分发给中国各地的医生，包括三个部分：调查医生的基本特征、EGFR exon20ins 突变 NSCLC 患者的诊断和治疗情况，以及医生对治疗选择的看法。参与本研究的医生每月治疗超过 10 例晚期 NSCLC 患者，且在过去六个月内治疗过晚期 EGFR exon20ins 突变 NSCLC 患者。
共发放了 53729 份问卷，回收了 390 份有效问卷。分别有 80.9%和 59.9%的接受一线或二线（以下简称“二线”）治疗的患者进行了 EGFR 突变检测。在治疗选择方面，化疗联合抗血管生成治疗是最常见的治疗选择（一线治疗中占 30.0%的患者；二线治疗中占 25.0%的患者），一定比例的患者在一线或二线治疗中接受了新型 EGFR exon20ins 靶向药物（包括酪氨酸激酶抑制剂[TKIs]和双特异性抗体），分别占所有治疗患者的 11.9%和 15.7%。此外，医生报告了靶向药物的疗效和安全性的最高满意度评分。大多数医生认为 EGFR exon20ins 靶向 TKI 是最有前途的治疗选择（一线治疗中占 80.2%，二线治疗中占 73.3%）。在几种正在研究的新型药物中，sunvozertinib 在疗效和安全性方面获得了最高的认可。
本研究调查了 EGFR exon20ins 突变 NSCLC 患者的当前诊断和治疗状况以及医生的看法。结果突出了该亚组患者存在重大的未满足的临床需求。EGFR exon20ins 靶向 TKI 被认为是最有前途的治疗方案，考虑到医生对靶向治疗的认识和接受程度，可能使更多患者受益。
