Xu Yingqi, Zhang Yidan, Jin Hongping, Zhong Hua, Xu Jianlin, Lou Yuqing, Zhong Runbo
Department of Respiratory and Critical Care Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ann Med. 2025 Dec;57(1):2493766. doi: 10.1080/07853890.2025.2493766. Epub 2025 Apr 25.
This study aimed to compare the efficacy of first-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) combined with low-dose bevacizumab(7.5 mg/kg) versus osimertinib as first-line treatment in patients with advanced EGFR-mutated non-small cell lung cancer (NSCLC).
A total of 161 patients with advanced NSCLC harboring EGFR mutations, who received first-line treatment at Shanghai Chest Hospital between July 2017 and July 2023, were enrolled in this study. Among them, 78 patients were treated with a combination of first-generation EGFR-TKIs and bevacizumab (7.5 mg/kg), constituting the bevacizumab plus TKI (A + T) group. The remaining 83 patients received osimertinib monotherapy (80 mg daily), forming the osimertinib group.
The objective response rate (ORR) was 65.4% (51/78) in the A + T group and 68.7% (57/83) in the osimertinib group ( = 0.657). Despite the potentially poorer baseline conditions of patients in the osimertinib group, the median progression-free survival (PFS) was 16.59 months (95% CI: 14.39-18.80) in the A + T group compared to 16.82 months (95% CI: 13.76-19.89) in the osimertinib group ( = 0.792). Preliminary overall survival (OS) analysis indicated a median OS of 51.75 months (95% CI: 41.63-61.86) in the A + T group versus 35.55 months (95% CI: 22.32-48.77) in the osimertinib group ( = 0.010), however, the OS data are not yet mature.
Although osimertinib remains the preferred first-line treatment for advanced NSCLC with EGFR mutations, combining first-generation EGFR-TKIs with low-dose bevacizumab may be a viable alternative for certain patients.
本研究旨在比较第一代表皮生长因子受体（EGFR）-酪氨酸激酶抑制剂（TKIs）联合低剂量贝伐单抗（7.5mg/kg）与奥希替尼作为晚期EGFR突变非小细胞肺癌（NSCLC）患者一线治疗的疗效。
本研究纳入了2017年7月至2023年7月期间在上海胸科医院接受一线治疗的161例携带EGFR突变的晚期NSCLC患者。其中，78例患者接受第一代EGFR-TKIs与贝伐单抗（7.5mg/kg）联合治疗，构成贝伐单抗加TKI（A+T）组。其余83例患者接受奥希替尼单药治疗（每日80mg），形成奥希替尼组。
A+T组的客观缓解率（ORR）为65.4%（51/78），奥希替尼组为68.7%（57/83）（P=0.657）。尽管奥希替尼组患者的基线条件可能较差，但A+T组的中位无进展生存期（PFS）为16.59个月（95%CI：14.39-18.80），而奥希替尼组为16.82个月（95%CI：13.76-19.89）（P=0.792）。初步总生存期（OS）分析表明，A+T组的中位OS为51.75个月（95%CI：41.63-61.86），奥希替尼组为35.55个月（95%CI：22.32-48.77）（P=0.010），然而，OS数据尚未成熟。
尽管奥希替尼仍然是晚期EGFR突变NSCLC的首选一线治疗药物，但第一代EGFR-TKIs联合低剂量贝伐单抗可能是某些患者的可行替代方案。
