在EGFR突变的高级非小细胞肺癌中经过奥西默蒂尼布耐药后,阿法替尼布加贝瓦西祖马布组合:II期ABCD研究
Akito Hata1, Nobuyuki Katakami2, Naoto Takase2
1Division of Thoracic Oncology, Kobe Minimally Invasive Cancer Center, Japan.
Lung cancer (Amsterdam, Netherlands)
|October 11, 2024
概括
在EGFR突变非小细胞肺癌患者中,阿法替尼布加贝瓦西祖马布显示出对奥西默提尼布耐药的临床益处. 重生检查分析指导了对这种耐药群体的治疗选择.
科学领域:
- 在瘤学瘤学.
- 医学遗传学 医学遗传学
背景情况:
- 皮表皮生长因子受体 (EGFR) - 铁氨酸激酶抑制剂 (TKIs) 和血管内皮生长因子抑制剂在临床研究中显示出协同作用.
- 奥西默提尼布耐药性是EGFR突变非小细胞肺癌 (NSCLC) 治疗的一个重大挑战.
研究的目的:
- 评估阿法提尼布加贝瓦西祖马布在EGFR突变性NSCLC患者中对奥西默提尼布产生耐药性的临床疗效.
- 研究耐药性的分子机制及其与治疗反应的相关性.
主要方法:
- 一项前性研究招募了28名EGFR突变性NSCLC患者,这些患者在 osimertinib 失败后患上了NSCLC.
- 患者接受阿法提尼布和贝瓦西祖马布治疗,直到疾病进展.
- 用深度测序分析等离子体和/或组织rebiopsies进行了基因改变的分析.
主要成果:
- 应答率为17.9%,疾病控制率为78.6%.
- 无进展生存时间的中位数为2.7个月,总生存时间为9.3个月.
- 常见的抵抗机制包括TP53,T790M,不常见的EGFR突变和MET放大. 患有C797S或不常见EGFR突变的患者表现出一些反应,而T790M阳性或下游信号突变的患者没有反应.
结论:
- 阿法丁尼布加贝瓦西祖马布可以在选定的NSCLC患者群体中提供临床益处,这些患者获得了奥西默蒂尼布耐药性.
- 重生检查和分子分析对于指导这种患者群体的治疗决策至关重要.
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