Zhang Jing, Zhang Zhao, Zhou Ying, Huang Chongbiao
Department of Integrative Oncology, Tianjin Cancer Hospital Airport Hospital Tianjin 300000, China.
Department of Integrative Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy Tianjin 300060, China.
Am J Transl Res. 2024 Dec 15;16(12):7553-7562. doi: 10.62347/TOYK7025. eCollection 2024.
To investigate the clinical effect of Almonertinib in in patients with epidermal growth factor receptor (EGFR) mutation-positive residual ground-glass opacities following resection of stage I lung cancer.
A retrospective analysis of 75 patients with EGFR mutation-positive residual ground-glass opacities post-stage I lung cancer surgery was conducted at Tianjin Medical University Cancer Institute and Hospital between January 2021 and December 2023. Patients were categorized into the control group (CG, n = 33, treated with pemetrexed and cisplatin) and the observation group (OG, n = 42, treated with Almonertinib). Cellular immune markers, tumor markers, CT nodule characteristics (size, density), malignancy risk scores before (T0) and after treatment (T1), treatment efficacy at T1, and adverse drug reactions were evaluated.
At T1, both groups showed an increase in CD3+ and CD4+ levels, and a decrease in CD8+ levels compared to T0. The OG group had significantly higher CD3+ and CD4+ levels and lower CD8+ levels compared to the CG group (all P < 0.05). Serum levels of IL-6, IL-8, and TNF-α decreased significantly in both groups at T1, with greater reductions observed in the OG group (all P < 0.05). Additionally, the OG group demonstrated a more substantial reduction in serum carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 50, cytokeratin 19 fragment antigen 21-1, neuron-specific enolase, and carbohydrate antigen 19-9 levels compared to the CG group (all P < 0.05). Nodule size and density also decreased in both groups, with more significant reductions in the OG group at T1 (all P < 0.05). The Mayo and Brock model predictions indicated a significantly lower risk of malignancy at T1 in the OG group compared to T0 (all P < 0.05). The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the OG group (P < 0.05), and adverse reaction rates were lower in the OG group compared to the CG group at T1 (all P < 0.05).
Almonertinib demonstrates good clinical efficacy and safety for the treatment of EGFR mutation-positive residual ground-glass opacities following stage I lung cancer resection.
探讨阿美替尼治疗Ⅰ期肺癌切除术后表皮生长因子受体(EGFR)突变阳性残留磨玻璃影患者的临床疗效。
对2021年1月至2023年12月在天津医科大学肿瘤医院接受治疗的75例Ⅰ期肺癌术后EGFR突变阳性残留磨玻璃影患者进行回顾性分析。将患者分为对照组(CG,n = 33,接受培美曲塞和顺铂治疗)和观察组(OG,n = 42,接受阿美替尼治疗)。评估细胞免疫标志物、肿瘤标志物、CT结节特征(大小、密度)、治疗前(T0)和治疗后(T1)的恶性风险评分、T1时的治疗疗效以及药物不良反应。
在T1时,与T0相比,两组的CD3+和CD4+水平均升高,CD8+水平降低。与CG组相比,OG组的CD3+和CD4+水平显著更高,CD8+水平更低(均P < 0.05)。在T1时,两组的血清白细胞介素-6、白细胞介素-8和肿瘤坏死因子-α水平均显著降低,OG组降低更明显(均P < 0.05)。此外,与CG组相比,OG组的血清癌胚抗原、糖类抗原125、糖类抗原50、细胞角蛋白19片段抗原21-1、神经元特异性烯醇化酶和糖类抗原19-9水平降低更显著(均P < 0.05)。两组的结节大小和密度也均降低,OG组在T1时降低更显著(均P < 0.05)。Mayo和Brock模型预测显示,与T0相比,OG组在T1时的恶性风险显著更低(均P < 0.05)。OG组的客观缓解率(ORR)和疾病控制率(DCR)显著更高(P < 0.05),且在T1时,OG组的不良反应发生率低于CG组(均P < 0.05)。
阿美替尼治疗Ⅰ期肺癌切除术后EGFR突变阳性残留磨玻璃影具有良好的临床疗效和安全性。