Superior efficacy of immunotherapy‐based combinations over monotherapy for EGFR ‐mutant non‐small cell lung cancer acquired resistance to EGFR‐TKIs

Autor: Ke Yang, Haiyan Xu, Lu Yang, Yuling Mi, Zhijie Wang, Xuezhi Hao, Guangjian Yang, Xingsheng Hu, Yaning Yang, Yan Wang
Rok vydání: 2020
Předmět:
Adult
Male
overall response rate (ORR)
0301 basic medicine
Pulmonary and Respiratory Medicine
Oncology
EGFR positive
medicine.medical_specialty
Lung Neoplasms
non‐small‐cell lung cancer (NSCLC)
medicine.medical_treatment
Population
non-small cell lung cancer (NSCLC)
Antineoplastic Agents
03 medical and health sciences
0302 clinical medicine
Carcinoma
Non-Small-Cell Lung
Internal medicine
medicine
Humans
Prospective Studies
education
Lung cancer
Protein Kinase Inhibitors
Aged
Retrospective Studies
Aged
80 and over
education.field_of_study
Univariate analysis
business.industry
Hazard ratio
Original Articles
General Medicine
Immunotherapy
Middle Aged
medicine.disease
Progression-Free Survival
ErbB Receptors
Clinical trial
Progression‐free survival (PFS)
030104 developmental biology
030220 oncology & carcinogenesis
Female
Original Article
immunotherapy
business
Progressive disease
Zdroj: Thoracic Cancer
ISSN: 1759-7714
1759-7706
DOI: 10.1111/1759-7714.13689
Popis: Background While prospective clinical studies on immunotherapy in epidermal growth factor receptor (EGFR) mutant non‐small‐cell lung cancer (NSCLC) with acquired resistance to EGFR tyrosine kinase inhibitors (TKIs) are ongoing, this study aimed to investigate the outcomes of immunotherapy combinations in such a population in a real‐world setting. Methods The clinical data of pretreated EGFR‐mutated NSCLC patients who acquired EGFR‐TKI resistance and received immunotherapy were retrospectively analyzed in this study. Progression‐free survival (PFS) was assessed using the Kaplan‐Meier log‐rank test, and univariate and multivariate analysis were performed. Results A total of 31 patients were analyzed in this study. A total of 25 (80.6%) patients received combination immunotherapy. In the univariate analysis, patients who received combination immunotherapy seemingly acquired longer PFS than those who received monotherapy, although there was no significant difference (3.42 months vs. 1.61; P = 0.078; hazard ratio (HR) 0.43, 95% CI: 0.16–1.13). Patients who received antiangiogenic drugs prior to immunotherapy acquired better PFS (3.42 months vs. 1.58; P = 0.027; HR 0.37, 95% CI: 0.15–0.93), while patients with liver metastasis had inferior PFS (2.04 months vs. 3.42; P = 0.031; HR 2.83, 95% CI: 1.05–7.60). Furthermore, multivariate analysis confirmed that the above three factors had independent prognostic value. Conclusions The study revealed that immunotherapy combinations are better choices than single‐agent regimens in previously treated and EGFR‐mutant NSCLC patients with progressive disease. In addition, antiangiogenic drugs administered before immunotherapy might be a favorable prognostic factor, while liver metastasis was associated with a short PFS in this setting. In future, more robust and prospective clinical trial results are expected to guide clinical practice. Key points Significant study findings Immunotherapy‐based combination therapies are better choices than single‐agent regimens in heavily treated EGFR‐mutant NSCLC patients. What this study adds Patients without liver metastasis and with prior antiangiogenic drugs obtained more benefit from immunotherapy in this setting.
Immunotherapy‐based combination therapies are better choices than single‐agent regimens in heavily treated EGFR‐mutant NSCLC patients. Patients without liver metastasis who have previously received antiangiogenic drugs obtain more benefit from immunotherapy in this setting.
Databáze: OpenAIRE
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