Osimertinib plus local treatment for brain metastases versus osimertinib alone in patients with EGFR-Mutant Non-Small Cell Lung Cancer.

Autor: Tozuka T; Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan., Noro R; Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan., Mizutani H; Department of Thoracic Oncology, Saitama Cancer Center, Saitama, Japan., Kurimoto F; Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association (JATA), Tokyo, Japan., Hakozaki T; Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan., Hisakane K; Department of Pulmonary Medicine and Oncology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan., Naito T; Department of Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan., Takahashi S; Respiratory Disease Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan., Taniuchi N; Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan., Yajima C; Department of Respiratory Medicine, Tokyo Rinkai Hospital, Tokyo, Japan., Hosomi Y; Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan., Hirose T; Department of Pulmonary Medicine and Oncology, Nippon Medical School Tama Nagayama Hospital, Tokyo, Japan., Minegishi Y; Department of Respiratory Medicine, Mitsui Memorial Hospital, Tokyo, Japan., Okano T; Respiratory Disease Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan., Kamio K; Department of Pulmonary Medicine, Nippon Medical School Musashikosugi Hospital, Kanagawa, Japan., Yamaguchi T; Department of Respiratory Medicine, Tokyo Rinkai Hospital, Tokyo, Japan., Seike M; Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. Electronic address: mseike@nms.ac.jp.
Jazyk: angličtina
Zdroj: Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2024 May; Vol. 191, pp. 107540. Date of Electronic Publication: 2024 Mar 24.
DOI: 10.1016/j.lungcan.2024.107540
Abstrakt: Objectives: Osimertinib is a standard treatment for patients with EGFR-mutant non-small cell lung cancer (NSCLC) and is highly effective for brain metastases (BMs). However, it is unclear whether local treatment (LT) for BMs prior to osimertinib administration improves survival in EGFR-mutant NSCLC. We aimed to reveal the survival benefit of upfront local treatment (LT) for BMs in patients treated with osimertinib.
Materials and Methods: This multicenter retrospective study included consecutive patients with EGFR mutation (19del or L858R)-positive NSCLC who had BMs before osimertinib initiation between August 2018 and October 2021. We compared overall survival (OS) and central nervous system progression-free survival (CNS-PFS) between patients who received upfront LT for BMs (the upfront LT group), and patients who received osimertinib only (the osimertinib-alone group). Inverse-probability treatment weighting (IPTW) analysis was performed to adjust for potential confounding factors.
Results: Of the 121 patients analyzed, 57 and 64 patients had 19del and L858R, respectively. Forty-five and 76 patients were included in the upfront LT group and the osimertinib-alone groups, respectively. IPTW-adjusted Kaplan-Meier curves showed that the OS of the upfront LT group was significantly longer than that of the osimertinib-alone group (median, 95 % confidence intervals [95 %CI]: Not reached [NR], NR-NR vs. 31.2, 21.7-33.2; p = 0.021). The hazard ratio (HR) for OS and CNS-PFS was 0.37 (95 %CI, 0.16-0.87) and 0.36 (95 %CI, 0.15-0.87), respectively.
Conclusions: The OS and CNS-PFS of patients who received upfront LT for BMs followed by osimertinib were significantly longer than those of patients who received osimertinib alone. Upfront LT for BMs may be beneficial in patients with EGFR-mutant NSCLC treated with osimertinib.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [Takehiro Tozuka has received honoraria from CHUGAI PHARMACEUTICAL and AstraZeneca. Rintaro Noro has received honoraria from CHUGAI PHARMACEUTICAL, AstraZeneca, Merck Pharmaceutical, Pfizer Pharmaceutical, Meijiseika Pharmaceutical, GlaxoSmithKline Pharmaceutical, Daiichi Sankyo Pharmaceutical, and has received Fund for the Promotion of Joint International Research (Fostering Joint International Research), and Grant-in-Aid for Scientific Research (C). Taiki Hakozaki has received honoraria from Chugai Pharmaceutical, Ono Pharmaceutical, and Eisai. Tomoyuki Naito has received honoraria from AstraZeneca. Yukio Hosomi has received honoraria from AstraZeneca, Eli Lilly Japan, Taiho Pharmaceutical, Chugai Pharmaceutical, Ono Pharmaceutical, Bristol-Myers Squibb, Kyowa Kirin, Nippon Kayaku, Takeda, Eisai, Novartis, and Pfizer. Takashi Hirose has received honoraria from AstraZeneca. Tetsuya Okano has received honoraria from Taiho Pharmaceutical Co., Ltd., Chugai Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., AstraZeneca K.K., Bristol-Myers Squibb K.K., Eli Lilly Japan K.K., Takeda Pharmaceutical Co., Ltd, and has received from Payment for expert testimony from Pharmaceuticals and Medical Devices Agency. Masahiro Seike has received honoraria from AstraZeneca, MSD K.K, Chugai Pharmaceutical, Taiho Pharmaceutical, Eli Lilly, Ono Pharmaceutical, Bristol-Myers Squibb, Nippon Boehringer Ingelheim, Pfizer Novartis, Takeda Pharmaceutical, Kyowa Hakko Kirin, Nippon Kayaku, Daiichi-Sankyo Company, Merck Biopharma, Amgen inc, and has received grants or contracts from any entity from Taiho Pharmaceutical, Chugai Pharmaceutical, Eli Lilly, Nippon Boehringer Ingelheim, Nippon Kayaku, and Kyowa Hakko Kirin].
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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