Dawoud Rawan, Saman Harman, Rasul Kakil, Jibril Farah, Sahal Arwa, Al-Okka Randa, Mahfouz Yaser, Omar Nabil E, Hamad Anas, Mohsen Reyad, Kanbour Aladdin, Battikh Naim, Chandra Prem, Elazzazy Shereen
Department of Pharmacy, The National Center of Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.
Department of Pulmonary Medicine, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar.
Clin Med Insights Oncol. 2024 Oct 15;18:11795549241272490. doi: 10.1177/11795549241272490. eCollection 2024.
There has been significant improvement in treating metastatic non-small-cell lung cancer (mNSCLC) over the past 2 decades. The aim of this study is to describe the use of tyrosine kinase inhibitors (TKIs) in Qatar. This study focuses on the objective response rate (ORR) and reported adverse drug events (ADEs) of TKIs used for the management of patients with mNSCLC.
This is a descriptive retrospective cohort study. All non-small-cell lung cancers (NSCLCs) with epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations who received TKIs between 2015 and 2019 in Qatar were included. The TKIs used during this period include EGFR inhibitors such as afatinib, erlotinib, gefitinib, and osimertinib and ALK inhibitors such as alectinib and crizotinib. The response on each TKI was identified by reporting the ORR (as the sum of the complete response [CR] and the partial response [PR]), in addition stable disease (SD) and disease progression (DP) were reported. While ADEs were reported using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE).
A total of 63 patients were included, of which 36 cases (57.1%) expressed EGFR mutation, and 27 patients (42.9%) expressed ALK rearrangement. The ORR in EGFR inhibitors was as follows: osimertinib 40%, gefitinib 33%, afatinib 22%, and erlotinib 18%. However, the response to the ALK-targeted therapy was 43% with alectinib and 40% with crizotinib. A total of 112 ADEs were reported. They were distributed as 63.4% (71 of 112) with the anti-EGFR and 36.6% (41 of 112) ADEs with the ALK inhibitors. In the anti-EGFR group, the most common types of ADEs were dermatological toxicity 30%, whereas, in the anti-ALK group, gastrointestinal toxicity was the most common (29%).
The EGFR-targeted and ALK-targeted therapies appear to have acceptable clinical response rate and safety profile in our population. Close and frequent monitoring of adverse events is advised to ensure a good quality of life and prevent serious complications.
在过去20年中，转移性非小细胞肺癌（mNSCLC）的治疗有了显著改善。本研究的目的是描述卡塔尔酪氨酸激酶抑制剂（TKIs）的使用情况。本研究重点关注用于治疗mNSCLC患者的TKIs的客观缓解率（ORR）和报告的药物不良事件（ADEs）。
这是一项描述性回顾性队列研究。纳入了2015年至2019年期间在卡塔尔接受TKIs治疗的所有具有表皮生长因子受体（EGFR）或间变性淋巴瘤激酶（ALK）突变的非小细胞肺癌（NSCLCs）患者。在此期间使用的TKIs包括EGFR抑制剂，如阿法替尼、厄洛替尼、吉非替尼和奥希替尼，以及ALK抑制剂，如阿来替尼和克唑替尼。通过报告ORR（作为完全缓解[CR]和部分缓解[PR]之和）来确定每种TKI的疗效，此外还报告了疾病稳定（SD）和疾病进展（DP）情况。而ADEs则使用美国国立癌症研究所的不良事件通用术语标准（NCI-CTCAE）进行报告。
共纳入63例患者，其中36例（57.1%）表达EGFR突变，27例（42.9%）表达ALK重排。EGFR抑制剂的ORR如下：奥希替尼40%，吉非替尼33%，阿法替尼22%，厄洛替尼18%。然而，阿来替尼对ALK靶向治疗的缓解率为43%，克唑替尼为40%。共报告了112例ADEs。它们的分布情况为，抗EGFR药物导致的ADEs占63.4%（112例中的71例），ALK抑制剂导致的ADEs占36.6%（112例中的41例）。在抗EGFR组中，最常见的ADEs类型是皮肤毒性，占30%，而在抗ALK组中，胃肠道毒性最为常见（29%）。
EGFR靶向治疗和ALK靶向治疗在我们的研究人群中似乎具有可接受的临床缓解率和安全性。建议密切且频繁地监测不良事件，以确保良好的生活质量并预防严重并发症。
