Prognostic Implication of PD-L1 Expression on Osimertinib Treatment for EGFR-mutated Non-small Cell Lung Cancer
Prognostic Implication of PD-L1 Expression on Osimertinib Treatment for EGFR-mutated Non-small Cell Lung Cancer
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DOI：
10.21873/anticanres.15736
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发表时间：
2022-05-01
影响因子：
2
通讯作者：
Hizawa, Nobuyuki
中科院分区：
文献类型：
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作者：
Shiozawa, Toshihiro;Numata, Takeshi;Hizawa, Nobuyuki
背景/目的：缺乏一线奥希替尼治疗表皮生长因子受体（EGFR）突变非小细胞肺癌（NSCLC）临床结果的真实世界数据。本研究旨在揭示奥希替尼作为临床实践中一线治疗的治疗结果和预后因素。患者和方法：我们回顾性评估了 2018 年 8 月至 2020 年 3 月期间日本 12 家机构接受奥希替尼作为一线治疗的 EGFR 突变 NSCLC 患者的临床结果。结果：在 158 名入组患者中，客观缓解率 (ORR) 为 68%，估计中位无进展生存期 (PFS) 为 17.1 个月 [95% 置信区间] (CI)=14.5-19.7]。亚组分析显示，程序性死亡配体 1 (PD-L1) 高表达组的 PFS 显着短于 PD-L1 低表达或无表达组（10.1 个月 vs. 16.1 个月 vs. 19.0 个月；p=0.03）。单变量和多变量分析表明，PD-L1 高表达是奥希替尼结果与 PFS 相关的唯一独立不良预后因素（风险比=2.71；95%CI=1.26-5.84；p=0.01）。在抗肿瘤反应方面，PD-L1表达与ORR之间没有统计学上显着的相关性（67% vs. 76% vs. 65%；p=0.51）。 PD-L1 与奥希替尼新耐药发生率之间也没有发现显着相关性 (p=0.39)。结论：虽然 PD-L1 表达与两者均无关
Background/Aim: Real-world data on the clinical outcomes of first-line osimertinib treatment for non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations is lacking. This study aimed to reveal the treatment outcomes and prognostic factors of osimertinib as first-line therapy in clinical practice settings. Patients and Methods: We retrospectively evaluated clinical outcomes of patients with EGFR-mutated NSCLC treated with osimertinib as first-line therapy across 12 institutions in Japan between August 2018 and March 2020. Results: Among 158 enrolled patients, the objective response rate (ORR) was 68%, and the estimated median progression-free survival (PFS) was 17.1 months [95% confidence interval (CI)=14.5-19.7]. Subgroup analysis showed that PFS in the group with high programmed death-ligand 1 (PD-L1) expression was significantly shorter than that in groups with low or no PD-L1 expression (10.1 vs. 16.1 vs. 19.0 months; p=0.03). Univariate and multivariate analyses demonstrated that high PD-L1 expression was the only independent adverse prognostic factor of osimertinib outcome related to PFS (hazard ratio=2.71; 95%CI=1.26-5.84; p=0.01). In terms of anti-tumor response, there was no statistically significant correlation between PD-L1 expression and the ORR (67% vs. 76% vs. 65%; p=0.51). No significant correlation was also found between PD-L1 and the incidence of de novo resistance to osimertinib (p=0.39). Conclusion: Although PD-L1 expression was not associated with either