EGFR突变非小细胞肺癌合并脑转移治疗方案的临床疗效和预后分析：一项回顾性研究。
Clinical efficacy and prognosis analysis of treatment regimens for EGFR mutant non-small cell lung cancer and brain metastasis: a retrospective study.
发表日期：2023 Mar 30
作者：
Huijuan Wang, Ruyue Xing, Mengmeng Li, Mina Zhang, Chunhua Wei, Guowei Zhang, Yuanyuan Niu, Zhiyong Ma, Xiangtao Yan
来源：
Brain Structure & Function
摘要：
这项研究的目的是评估中国EGFR突变（m+）非小细胞肺癌（NSCLC）患者一线治疗中可能的差异，并确定影响生存结果的因素。在这项回顾性研究中，共研究了172例EGFRm+晚期NSCLC患者，这些患者接受了第一代EGFR酪氨酸激酶抑制剂（TKI），并被分为四组：A，EGFR-TKI（n=84）；B，EGFR-TKI+pemetrexed+cisplatin/carboplatin化疗（CT）（n=55）；C，EGFR-TKI+bevacizumab（n=15）；D，EGFR-TKI+pemetrexed+cisplatin/carboplatin CT+bevacizumab（n=18）。分析了颅内和颅外进展自由生存期（PFS）、总生存期（OS）、客观缓解率（ORR）和不良事件。C+D组颅内PFS比A+B组更长（18.9个月对11.0个月，P=0.027）。与A组相比，B组颅外PFS更长（13.0个月对11.5个月，P=0.039），而C+D组比A+B组颅外PFS更长（18.9个月对11.9个月，P=0.008）。A和B组的中位OS分别为27.9个月和24.4个月，而C和D组的中位OS尚未达到。在A+B组与C+D组之间发现颅内ORR显著差异（31.0%对65.2%，P=0.002）。大多数患者经历了1-2级与治疗相关的不良事件，这些事件经过对症治疗后很快得到缓解。第一代EGFR-TKI+bevacizumab治疗在EGFRm+ NSCLC患者的脑转移中优于其他方案。这种治疗在控制和延迟颅内病变进展以及延长生存时间方面表现良好。©2023. The Author(s).
The aims of the study were to evaluate potential differences among first-line treatment for EGFR mutant (m+) non-small cell lung cancer (NSCLC) patients with brain metastasis in China and to identify the factors influencing survival outcomes.In this retrospective study, 172 EGFRm + patients with advanced NSCLC who received a 1st generation EGFR tyrosine kinase inhibitor (TKI) were divided into 4 groups: A, EGFR-TKI (n = 84); B, EGFR-TKI + pemetrexed + cisplatin/carboplatin chemotherapy (CT) (n = 55); C, EGFR-TKI + bevacizumab (n = 15); and D, EGFR-TKI + pemetrexed + cisplatin/carboplatin CT + bevacizumab (n = 18). Intracranial and extracranial progression-free survival (PFS), the overall survival (OS), objective remission rates (ORRs) and adverse events were analyzed.Intracranial PFS of groups C + D was longer than for groups A + B (18.9 m vs. 11.0 m, P = 0.027). Extracranial PFS were longer in group B in comparison with group A (13.0 m vs. 11.5 m, P = 0.039) and in groups C + D compared to groups A + B (18.9 m vs. 11.9 m, P = 0.008). Median OS in groups A and B were 27.9 m and 24.4 m, respectively, while groups C and D have not yet achieved median OS. Significant difference was found in intracranial ORR between groups A + B vs. C + D (31.0% vs. 65.2%, P = 0.002). Most patients suffered grade 1-2 treatment-related adverse events, which were relieved soon after symptomatic treatment.First-generation EGFR-TKI + bevacizumab treatment outperformed other regimens in EGFRm + NSCLC patients with brain metastasis. The therapy improved the control and delayed progression of intracranial lesions and prolonged survival times.© 2023. The Author(s).