Huang Shijie, Fan Mengying, Peng Kaiming, Yan Wanpu, Chen Boyang, Wang Wu, Yang Tianbao, Chen Keneng, Kang Mingqiang, Xie Jinbiao
Department I of Cardiothoracic Surgery, The Affiliated Hospital of Putian University, Putian 351100, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department I of Thoracic Surgery, Peking University Cancer Hospital & Institute, Beijing 100142, China.
Zhongguo Fei Ai Za Zhi. 2025 Jul 20;28(7):487-496. doi: 10.3779/j.issn.1009-3419.2025.106.18.
The proportion of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is relatively high in China. However, these patients currently lack significant benefits from available neoadjuvant treatment options. This study aims to explore the potential application value of neoadjuvant targeted therapy by evaluating its efficacy and safety in patients with EGFR-mutant resectable lung adenocarcinoma.
A multicenter retrospective study was used to analyze the treatment effect of patients with stage IIA-IIIB EGFR-mutant lung adenocarcinoma who underwent surgical resection after receiving neoadjuvant targeted therapy from July 2019 to October 2024.
A total of 24 patients with EGFR-mutant lung adenocarcinoma from three centers were included in this study. All patients successfully underwent surgery and achieved R0 resection of 100.0%. The objective response rate (ORR) was 83.3% (20/24) . The major pathologic response (MPR) rate was 37.5% (9/24), with 2 patients (8.3%) achieving pathological complete response (pCR). During neoadjuvant therapy, 13 out of 24 patients (54.2%) experienced adverse events of grade 1-2, with no occurrences of ≥ grade 3. The most common treatment-related adverse events were rash (n=4, 16.7%), mouth sores (n=2, 8.3%), and diarrhea (n=2, 8.3%). The median follow-up time was 33.0 months, no deaths occurred in all patients, and the overall survival (OS) rate was 100.0%. The 1-year disease-free survival (DFS) rate was 91.1%, and the 2-year DFS rate remained at 86.2%.
The application of neoadjuvant targeted therapy in patients with EGFR-mutant resectable lung adenocarcinoma is safe and feasible, and is expected to become a highly promising neoadjuvant treatment option for the patients with EGFR-mutant lung adenocarcinoma.
在中国，携带表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）患者比例相对较高。然而，这些患者目前从现有的新辅助治疗方案中获益并不显著。本研究旨在通过评估新辅助靶向治疗在EGFR突变的可切除肺腺癌患者中的疗效和安全性，探索其潜在的应用价值。
采用多中心回顾性研究，分析2019年7月至2024年10月期间接受新辅助靶向治疗后接受手术切除的IIA-IIIB期EGFR突变肺腺癌患者的治疗效果。
本研究共纳入来自三个中心的24例EGFR突变肺腺癌患者。所有患者均成功接受手术，R0切除率达100.0%。客观缓解率（ORR）为83.3%（20/24）。主要病理缓解（MPR）率为37.5%（9/24），2例患者（8.3%）达到病理完全缓解（pCR）。新辅助治疗期间，24例患者中有13例（54.2%）发生1-2级不良事件，无≥3级不良事件发生。最常见的治疗相关不良事件为皮疹（n=4，16.7%）、口腔溃疡（n=2，8.3%）和腹泻（n=2，8.3%）。中位随访时间为33.0个月，所有患者均无死亡，总生存率（OS）为IOO.O%。1年无病生存率（DFS）为91.1%，2年DFS率仍为86.2%。
新辅助靶向治疗在EGFR突变的可切除肺腺癌患者中的应用安全可行，有望成为EGFR突变肺腺癌患者极具前景的新辅助治疗选择。
