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表皮生长因子受体(EGFR)突变的晚期非鳞状非小细胞肺癌(NSCLC)患者采用吉非替尼联合贝伐单抗和化疗进行一线治疗。

First-line treatment with gefitinib in combination with bevacizumab and chemotherapy in advanced non-squamous NSCLC with EGFR-mutation.

机构信息

Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin, China.

Tianjin's Clinical Research Center for Cancer, Tianjin, China.

出版信息

BMC Cancer. 2024 Oct 29;24(1):1326. doi: 10.1186/s12885-024-13084-x.

Abstract

BACKGROUND

The safety and efficacy of combination of gefitinib with chemotherapy and bevacizumab in treatment patients with epidermal growth factor receptor (EGFR) mutations are currently unknown. This study was designed to evaluate the safety and preliminary efficacy of a combination therapy consisting of gefitinib, bevacizumab, pemetrexed, and carboplatin in patients with advanced non-squamous non-small cell lung cancer (NSCLC) harboring EGFR mutations.

METHODS

Eligible patients with EGFR-mutated advanced non-squamous NSCLC were recruited and received gefitinib combination with bevacizumab plus pemetrexed and carboplatin treatment. The primary endpoints were safety and progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and overall survival (OS).

RESULTS

From June 2019 to June 2021, 20 patients were enrolled in this study. The median follow-up was 33.8 months (95% CI, 31.0-36.6). Grade ≥ 3 adverse events was 65%, including neutropenia (30%), thrombocytopenia (20%), nausea (20%), skin rash (20%), bleeding (10%), and increased ALT (10%). There was no death related to toxicity occurred. The median PFS was 28 months (95% CI, 20.4-35.6). the ORR was 95% (95% CI, 75.1-99.9%), the DCR was 100% (95% CI, 83.2-100%), and the median DOR was 26.4 months (95% CI, 18.9-33.9). The median OS has not been reached.

CONCLUSION

The results of this study demonstrate that the four-drug combination regimen, led by gefitinib, is manageable and tolerated and effective for patients with EGFR-mutated advanced non-squamous NSCLC.

摘要

背景

目前尚不清楚表皮生长因子受体(EGFR)突变患者联合使用吉非替尼、化疗和贝伐珠单抗的安全性和疗效。本研究旨在评估吉非替尼联合贝伐珠单抗、培美曲塞和卡铂治疗携带 EGFR 突变的晚期非鳞状非小细胞肺癌(NSCLC)患者的安全性和初步疗效。

方法

招募 EGFR 突变的晚期非鳞状 NSCLC 患者,并接受吉非替尼联合贝伐珠单抗加培美曲塞和卡铂治疗。主要终点为安全性和无进展生存期(PFS)。次要终点包括客观缓解率(ORR)、疾病控制率(DCR)、缓解持续时间(DOR)和总生存期(OS)。

结果

从 2019 年 6 月至 2021 年 6 月,共有 20 名患者入组本研究。中位随访时间为 33.8 个月(95%CI,31.0-36.6)。≥3 级不良事件发生率为 65%,包括中性粒细胞减少(30%)、血小板减少(20%)、恶心(20%)、皮疹(20%)、出血(10%)和 ALT 升高(10%)。无与毒性相关的死亡。中位 PFS 为 28 个月(95%CI,20.4-35.6)。ORR 为 95%(95%CI,75.1-99.9%),DCR 为 100%(95%CI,83.2-100%),中位 DOR 为 26.4 个月(95%CI,18.9-33.9)。中位 OS 尚未达到。

结论

本研究结果表明,以吉非替尼为基础的四药联合方案治疗携带 EGFR 突变的晚期非鳞状 NSCLC 患者是可控且耐受良好的,并且是有效的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/965f/11520869/79e6486f950d/12885_2024_13084_Fig1_HTML.jpg

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