Depth of Response was Associated with Progression-Free Survival in Patients with Advanced Non-small Cell Lung Cancer treated with EGFR-TKI
Depth of Response was Associated with Progression-Free Survival in Patients with Advanced Non-small Cell Lung Cancer treated with EGFR-TKI
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DOI：
10.7150/jca.33450
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Shi, Yuan-Kai
中科院分区：
文献类型：
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作者：
Liu, Yu-Tao;Zhang, Kai;Shi, Yuan-Kai
背景：实体肿瘤反应评价标准（RECIST）已被广泛用于评价新的肿瘤治疗策略。然而，RECIST未能评估高活性治疗中反应的异质性。反应深度（DepOR），定义为肿瘤大小与基线相比的最大变化百分比，可能提供一种评估疾病反应的新策略。在本研究中，我们研究了表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）治疗的晚期非小细胞肺癌（NSCLC）患者的DepOR与无进展生存期（PFS）之间的关系。方法：回顾性收集2014年8月至2017年7月两个地点的EGFR- tki治疗的EGFR驱动突变（L858R或外显子19缺失）晚期NSCLC患者进行分析。采用DepOR法将患者分为四组（Q1 = 1-25%, Q2 = 26-50%, Q3 = 51-75%, Q4 = 76-100%）。绘制PFS与DepOR的Kaplan-Meier曲线，并通过单变量和多变量cox回归模型确定风险比（HR）。结果：共纳入265例患者进行分析。Q1-Q4组患者分别为91例（34.3%）、73例（27.5%）、65例（24.5%）、36例（13.6%）。更大的DepOR与更长的PFS显著相关(Log-rank P
Background: Response Evaluation Criteria in Solid Tumors (RECIST) has been widely utilized to evaluate new therapeutic strategies in cancer. However, RECIST fails to assess the heterogeneity of response in highly active therapies. Depth of response (DepOR), defined as the maximum percentage change in tumor size compared with baseline, may provide a new strategy to evaluate disease response. In the present study, we studied the association between DepOR and progression-free survival (PFS) in patients with advanced non-small cell lung cancer (NSCLC) treated with epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).Methods: Advanced NSCLC patients harboring EGFR driver mutation (L858R or exon 19 deletion) treated with EGFR-TKI from August 2014 to July 2017 from two sites were retrospetively collected for analysis. Patients were divided into four groups by DepOR (Q1 = 1-25%, Q2 = 26-50%, Q3 = 51-75%, Q4 = 76-100%). Kaplan-Meier curves were plotted for PFS against DepOR and the hazard ratio (HR) was determined through univariable and multivariable cox regression models.Results: In total, 265 patients were included for analysis. The number of patients in Group Q1-Q4 were 91 (34.3%), 73 (27.5%), 65 (24.5%) and 36 (13.6%), respectively. A greater DepOR was significantly associated with a longer PFS (Log-rank P