持续下一代ALK TKIs与化学疗法对高级ALK阳性NSCLC的有效性和安全性:一个多中心回顾性研究
Sarah Waliany1, Shambo Guha Roy2, Federica Pecci3
11Massachusetts General Hospital Cancer Center, Massachusetts General Hospital, Boston, MA.
Journal of the National Comprehensive Cancer Network : JNCCN
|February 11, 2026
概括
持续使用下一代ALK氨酸激酶抑制剂 (TKIs) 与/pemetrexed化疗改善了ALK阳性高级非小细胞肺癌患者的无进展生存率和整体生存率. 这种联合治疗也减少了内进展,没有新的安全问题.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 下一代ALK氨酸激酶抑制剂 (TKIs) 是ALK阳性的先进/转移性非小细胞肺癌 (NSCLC) 的第一线治疗方法.
- /pemetrexed (PT/Pem) 化疗是一种标准的下一线疗法,但对PT/Pem后进展的持续TKI的数据有限.
研究的目的:
- 评估在ALK+转移性NSCLC中TKI进展后,与PT/Pem单独治疗相比,继续使用下一代ALK TKIs与PT/Pem化疗的疗效和安全性.
主要方法:
- 对156名ALK+转移性NSCLC患者进行了回顾性多中心研究.
- 患者接受PT/Pem单独或PT/Pem与alectinib或lorlatinib (PT/Pem/TKI) 结合,在此之前的下一代ALK TKI治疗后.
- 终点包括无进展生存 (PFS),总生存 (OS),内进展和与治疗相关的不良事件 (trAEs).
主要成果:
- 结合PT/Pem/TKI,与单独PT/Pem相比,PFS中位数在数值上更长 (6.0个月与3.5个月).
- 在接受一线TKIs治疗的患者中,PT/Pem/TKI显著改善了中位数PFS (6.6 vs 3.5个月) 和中位数OS (16.4 vs 11.4个月) 与单独PT/Pem相比.
- 与单独使用PT/Pem相比,PT/Pem/TKI显著降低了12个月内内进展的累计发病率 (18.7%与34.0%相比),没有意外的安全信号.
结论:
- 继续下一代ALK TKIs与PT/Pem化疗改善ALK+NSCLC患者的PFS和OS,这些患者在TKI单疗中进展.
- 这种组合策略表明,减少了内进展,没有显著的新毒性.
- 这些发现凸显了对TKI耐火性ALK+NSCLC的新疗法的需求,尽管结合治疗的好处很大.
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