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在EGFR突变NSCLC中症状性BM的最佳LT序列:一线EGFR-TKI与/或没有前期LT的比较研究

Lishui Niu¹, Honghua Wu², Ruihuan Gao¹

¹Department of Oncology, Xiangya Hospital, Central South University, 87 Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China.

Journal of cancer research and clinical oncology

|February 18, 2024

概括

前期局部治疗与第三代EGFR-TKIs相结合,可以改善非小细胞肺癌患者的整体存活率,这些患者有症状的大脑转移. 这种组合疗法,特别是对于形肌瘤患者,需要在更大规模的前性研究中进一步调查.

科学领域:

在瘤学瘤学.
神经瘤学神经瘤学
药理学药理学是指药理学的学科.

背景情况:

第三代EGFR-TKIs有效地治疗EGFR突变NSCLC的脑转移 (BM),这是由于血脑屏障的透导致的.
由于对神经症状患者的临床试验注册有限,对症状性骨瘤的局部治疗 (LT) 和EGFR-TKIs的最佳序列尚不清楚.

研究的目的:

评估前期局部治疗 (uLT) 加上第三代EGFR-TKI与单独的EGFR-TKI在非小细胞肺癌 (NSCLC) 患者中具有症状大脑转移 (BM) 的疗效和安全性.
探索BM负担对这一患者群体的生存结果的影响.

主要方法:

对86名EGFR突变NSCLC患者的回顾性分析,这些患者有症状的BMs,接受一线 osimertinib 或 aumolertinib.
患者被分为两组:单独的第三代EGFR-TKI (TKI) 和预先的LT加第三代EGFR-TKI (TKI + uLT).
评估的结果包括总生存率 (OS),无进展生存率 (PFS),内PFS (iPFS),治疗失败模式和不良事件,并对BM数进行亚组分析.

主要成果:

在TKIs和TKIs + uLT组之间,短期反应没有显著差异.
与TKIs + uLT组相比,TKIs + uLT组的生存期 (43个月与28个月;HR 0.36) 显著更长.
亚组分析显示,在接受TKIs + uLT (43 vs 31个月;HR 0.22) 的oligo-BM患者中,延长了OS. 没有观察到PFS,iPFS,故障模式或安全性的差异.

结论:

前期局部治疗与第三代EGFR-TKIs结合可能有利于EGFR突变NSCLC患者的症状BMs,特别是那些有限的BMs (oligo-BM).
需要进行更大规模的前性研究来证实TKIs + uLT治疗策略的有效性.

关键词:

在EGFR的突变中.非小细胞肺癌是非小细胞肺癌.生存结果的结果.有症状的大脑转移.第三代EGFR技术技术技术.前期的局部治疗.

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