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EGFR遺伝子変異陽性進行非小細胞肺癌に対するEGFR-TKIとベバシズマブ併用療法のメタアナリシス

Zexian Wang¹, Yaru Guo¹, Xiaohan Qin¹

¹Department of Radiation, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China.

Clinical Medicine Insights. Oncology

|January 26, 2026

まとめ

EGFR遺伝子変異陽性の進行非小細胞肺癌（NSCLC）患者において、EGFRチロシンキナーゼ阻害薬（TKI）へのベバシズマブの併用は、治療成績を著しく改善する。この併用療法は、管理可能な安全性プロファイルで、生存期間の延長に寄与する。

科学分野:

腫瘍学; 医学研究; 薬理学

背景:

EGFR感受性変異陽性の進行非小細胞肺癌（NSCLC）の治療は困難である。EGFRチロシンキナーゼ阻害薬（TKI）は標準治療である。EGFR-TKIへのベバシズマブの追加が有効性向上のために調査されている。

研究の目的:

EGFR-TKIとベバシズマブの併用療法とEGFR-TKI単剤療法の有効性と安全性を評価する。奏効率、無増悪生存期間（PFS）、全生存期間（OS）への影響を評価する。発疹や肺炎などの有害事象を含む安全性プロファイルを分析する。

主な方法:

14件のランダム化比較試験の包括的なメタアナリシスを実施した。2023年10月まで、複数のデータベース（CNKI、Wanfang、CBM、VIP、PubMed、Embase、Cochrane Library、Web of Science）から研究を特定した。比較は、EGFR遺伝子変異陽性の進行NSCLCにおけるEGFR-TKIとベバシズマブの併用療法対EGFR-TKI単剤療法に焦点を当てた。

主要な成果:

併用療法は、奏効率（OR=1.33）および客観的奏効率（OR=1.52）を有意に改善した。疾患進行は有意に減少し（OR=0.31）、1年（OR=2.04）および2年（OR=1.38）の無増悪生存期間（PFS）が延長した。1年全生存期間（OS）の有意な改善（OR=1.41）が観察され、安全性プロファイルは管理可能であった。

結論:

EGFR遺伝子変異陽性の進行NSCLCにおいて、ベバシズマブとEGFR-TKIの併用は、短期から中期にかけての生存期間を有意に延長する。安全性プロファイルは許容範囲であり、高血圧や下痢などの管理可能な副作用の増加が予想される。この併用療法は、この患者集団における有用な一次治療選択肢となる。

キーワード:

EGFR 非小細胞肺癌ベバシズマブチロシンキナーゼ阻害薬

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