Department of Medical Oncology, University Clinic Golnik, 4204 Golnik, Slovenia.
Medical Faculty Ljubliana, University of Ljubliana, 1000 Ljubljana, Slovenia.
Curr Oncol. 2024 Jul 30;31(8):4369-4381. doi: 10.3390/curroncol31080326.
ROS1 rearrangements are considered rare in non-small-cell lung cancer (NSCLC). This retrospective real-world study aimed to evaluate first-line treatment with crizotinib, a tyrosine kinase inhibitor (TKI) standard of care vs. new generation ROS1 anti-cancer agents. Forty-nine ROS1-expressing NSCLC patients, diagnosed with advanced metastatic disease, were included. Molecular profiling using either FISH/CISH or NGS was performed on tissue samples. Twenty-eight patients were treated with crizotinib, while fourteen patients were administered newer drugs (entrectinib, repotrectinib) and seven patients received platinum-doublet chemotherapy in a first-line setting. Overall response rate and disease control rate for the crizotinib and entrectinb/repotrectinib cohort were 68% and 82% vs. 86% and 93%, respectively. Median progression free survival was 1.6 years (95% CI 1.15-2.215) for the crizotinib treatment vs. 2.35 years for the entrectinib/repotrectinib cohort (95% CI 1.19-3.52). Central nervous system progression was noted in 20% and 25% of the crizotinib and entrectinib/repotrectinib cohorts, respectively. This multi-center study presents real-world treatment patterns of ROS1 NSCLC population, indicating that crizotinib exhibited comparable results to entrectinib/repotrectinib in a first-line setting, although both response rate and survival was numerically longer with treatment with newer agents.
ROS1 重排被认为在非小细胞肺癌（NSCLC）中较为罕见。本回顾性真实世界研究旨在评估克唑替尼（一种酪氨酸激酶抑制剂[TKI]标准治疗药物）与新一代 ROS1 抗癌药物作为一线治疗的效果。共纳入 49 例 ROS1 表达的 NSCLC 患者，均诊断为晚期转移性疾病。对组织样本进行了荧光原位杂交（FISH/CISH）或下一代测序（NGS）的分子谱分析。28 例患者接受了克唑替尼治疗，14 例患者接受了新一代药物（恩曲替尼、瑞波替尼）治疗，7 例患者在一线治疗中接受了铂类双重化疗。克唑替尼和恩曲替尼/瑞波替尼组的总缓解率和疾病控制率分别为 68%和 82%，86%和 93%。克唑替尼治疗组的中位无进展生存期为 1.6 年（95%CI：1.15-2.215），恩曲替尼/瑞波替尼组为 2.35 年（95%CI：1.19-3.52）。克唑替尼和恩曲替尼/瑞波替尼组分别有 20%和 25%的患者出现中枢神经系统进展。这项多中心研究展示了 ROS1 NSCLC 患者的真实世界治疗模式，表明克唑替尼在一线治疗中与恩曲替尼/瑞波替尼的疗效相当，尽管新一代药物治疗的反应率和生存率在数值上更长。
