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一线并发EGFR-TKI+化疗与单独使用EGFR-TKI治疗晚期EGFR突变NSCLC:随机III期试验的元分析

Thierry Landre¹, Jean-Baptiste Assié^2,3,4, Kader Chouahnia⁵

¹Unité d'Oncologie et Gériatrie, HUPSSD, Hôpital René Muret, AP-HP, Sevran, France.

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概括

将化疗添加到表皮生长因子受体氨酸激酶抑制剂 (EGFR-TKI) 中,可显著改善晚期非小细胞肺癌 (NSCLC) 患者的无进展存活率 (PFS) 和整体存活率 (OS). 这种组合疗法对脑转移患者具有特别的益处.

科学领域:

在瘤学瘤学.
医学研究医学研究

背景情况:

患有表皮生长因子受体 (EGFR) 突变的高级非小细胞肺癌 (NSCLC) 的一线治疗通常涉及铁酶抑制剂 (TKIs).
在这种患者群体中,研究结合化疗 (ChT) 与EGFR-TKIs的疗效具有重要的临床意义.

研究的目的:

进行第三期随机试验的元分析,比较EGFR-TKI加化学疗法 (EGFR-TKI + ChT) 组合与单独使用EGFR-TKI作为第一线治疗.
评估这种组合对具有激活EGFR突变的晚期NSCLC患者无进展生存期 (PFS) 和整体生存期 (OS) 的影响.

主要方法:

对四项符合条件的III期随机试验 (NEJ009,GAP-Brain,Noronha等人,FLAURA-2) 的元分析,涉及1413名患有非状细胞性NSCLC的患者.
对EGFR-TKI + ChT和单独EGFR-TKI之间的结局进行比较,重点是EGFR exon-19缺失 (ex19del) 或L858R突变的患者.

主要成果:

与单独使用EGFR-TKI相比,EGFR-TKI + ChT组合显示了PFS (HR:0.52;p < 0.0001) 和OS (HR:0.69;p = 0.01) 的显著改善.
在患有脑转移的患者中,无进展生存 (PFS) 特别增强 (HR:0.41;p < 0.00001).

结论:

结合EGFR-TKI和化疗,为未经治疗,晚期,EGFR突变的NSCLC患者提供显著的生存益处.
需要进行进一步的研究,以准确确定将从这种联合治疗方法中获得最大益处的患者子组.

关键词:

欧洲农业基金会 (EGFR) 是一个.非小细胞肺癌是非小细胞肺癌.化疗化疗是一种化学疗法.盖菲提尼布 (gefitinib) 是一种药物.这是一个元分析.奥西米尔丁尼布 (osimertinib) 是一种

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