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家族和个人病史对非小细胞肺癌(NSCLC)中酪氨酸激酶抑制剂(TKIs)治疗结果的影响

Effect of Family and Personal Medical History on Treatment Outcomes of Tyrosine Kinase Inhibitors (TKIs) in Non-Small Cell Lung Cancer (NSCLC).

作者信息

Surmeli Heves, Turkoglu Ezgi, Isik Deniz, Kinikoglu Oguzcan, Altintas Yunus Emre, Ozkerim Ugur, Oksuz Sila, Basoglu Tugba, Odabas Hatice, Turan Nedim

机构信息

Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul 34865, Türkiye.

出版信息

Healthcare (Basel). 2025 Jul 25;13(15):1810. doi: 10.3390/healthcare13151810.

DOI:10.3390/healthcare13151810
PMID:40805843
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12346163/
Abstract

: Tyrosine kinase inhibitors (TKIs) have significantly improved outcomes in non-small cell lung cancer (NSCLC), especially among patients with actionable genetic mutations. However, the influence of family and personal medical history (FPMH) on clinical and treatment outcomes with TKI therapy remains underexplored. : We conducted a retrospective cohort study involving 136 NSCLC patients receiving TKIs, categorized into two groups based on the presence or absence of documented FPMH. Clinical variables assessed included demographic data, comorbidities, Eastern Cooperative Oncology Group (ECOG) performance status, tumor characteristics, genetic mutations (EGFR, ALK, ROS1), treatment responses, toxicity profiles, and survival outcomes. Statistical analyses included Chi-square tests, -tests, Mann-Whitney U tests, Spearman correlation, and univariate logistic regression ( < 0.05 threshold for significance). : Patients with FPMH (n = 34) had a significantly higher burden of chronic diseases (58.8% vs. 15.7%), poorer ECOG scores (≥3: 8.8% vs. 1.0%), increased recurrence (41.2% vs. 20.6%), and greater chemotherapy-related toxicity (50.0% vs. 28.4%) compared to those without FPMH (n = 102). However, there were no significant differences in survival duration or mutation status between the two groups. : FPMH may be a predictive factor for treatment complications and recurrence in NSCLC patients receiving TKIs, although it does not appear to influence survival or genetic mutation status. These findings support the need for personalized clinical monitoring strategies based on medical history.

摘要

酪氨酸激酶抑制剂(TKIs)显著改善了非小细胞肺癌(NSCLC)的治疗效果,尤其是在具有可操作基因突变的患者中。然而,家族和个人病史(FPMH)对TKI治疗的临床及治疗效果的影响仍未得到充分研究。

我们进行了一项回顾性队列研究,纳入了136例接受TKIs治疗的NSCLC患者,根据是否有记录的FPMH将其分为两组。评估的临床变量包括人口统计学数据、合并症、东部肿瘤协作组(ECOG)体能状态、肿瘤特征、基因突变(EGFR、ALK、ROS1)、治疗反应、毒性特征和生存结果。统计分析包括卡方检验、t检验、曼-惠特尼U检验、斯皮尔曼相关性分析和单因素逻辑回归(显著性阈值<0.05)。

与没有FPMH的患者(n = 102)相比,有FPMH的患者(n = 34)患有慢性病的负担显著更高(58.8%对15.7%),ECOG评分更差(≥3分:8.8%对1.0%),复发率增加(41.2%对20.6%),化疗相关毒性更大(50.0%对28.4%)。然而,两组之间的生存时间或突变状态没有显著差异。

FPMH可能是接受TKIs治疗的NSCLC患者治疗并发症和复发的预测因素,尽管它似乎不影响生存或基因突变状态。这些发现支持了基于病史制定个性化临床监测策略的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/7e0c7279b590/healthcare-13-01810-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/cc33c10641da/healthcare-13-01810-g005.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/7e0c7279b590/healthcare-13-01810-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/57148a928970/healthcare-13-01810-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/e365c83c8338/healthcare-13-01810-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ba0/12346163/7e0c7279b590/healthcare-13-01810-g007.jpg

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