Front-Line ICI-Based Combination Therapy Post-TKI Resistance May Improve Survival in NSCLC Patients With EGFR Mutation
| Autor: | Maoqiong Jiang, Min Yu, Meijuan Huang, Jiang Zhu, Qiang Zhou, Juan Li, Zhiyu Lin, Dai-Yuan Ma, Lin Chen, You Lu, Shubin Tang, Tian Tian, Youling Gong |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Multivariate analysis Combination therapy medicine.drug_class immune checkpoint inhibitor Tyrosine-kinase inhibitor resistance non–small cell lung cancer tyrosine kinase inhibitor Internal medicine medicine Clinical endpoint Epidermal growth factor receptor Prospective cohort study RC254-282 Original Research biology business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Front line Cohort biology.protein epidermal growth factor receptor business |
| Zdroj: | Frontiers in Oncology, Vol 11 (2021) Frontiers in Oncology |
| ISSN: | 2234-943X |
| DOI: | 10.3389/fonc.2021.739090 |
| Popis: | BackgroundData on the use of immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation are limited. The current study aimed to assess the efficacy of ICIs in EGFR-mutant advanced NSCLC and explore the relevant influential factors.Materials and MethodsRelevant clinical data of EGFR-mutant NSCLC patients who had received ICIs were collected from multiple hospitals. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), and relevant influential factors.ResultsA total of 122 advanced EGFR-mutant NSCLC patients were included in the final analysis. The total cohort had an objective response rate (ORR) of 32.0%, a median progression-free survival (mPFS) of 5.0 months, and a median overall survival (mOS) of 14.4 months. Among 96 patients with common EGFR mutations (19Del, 52 patients; L858R, 44 patients), those who were administered front-line ICI exhibited better survival benefits than those who received later-line ICI after disease progression on tyrosine kinase inhibitors (TKIs) treatment (mPFS: 7.2 months vs. 3.4 months, respectively, P < 0.0001; mOS: 15.1 months vs. 8.4 months, respectively, P vs. 2.2 months, respectively, P = 0.002; mOS: 14.4 months vs. 7.0 months, respectively, P = 0.001). Multivariate analysis showed that ICI-based combination therapy and front-line ICI administration after progression on EGFR-TKI were associated with significant improvements in both PFS and OS (P < 0.05). A high PD-L1 expression (tumor proportion score, TPS≥50%) and the EGFR L858R mutation were only significantly associated with a better PFS (P ConclusionsTaken together, combination immunotherapy in front-line was associated with improvement of survival in EGFR-mutant NSCLC patients post-TKI resistance. Further prospective studies with large sample sizes are required to identify the optimal combinatorial treatment strategy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|