Crizotinib in patients with anaplastic lymphoma kinase-positive advanced non-small cell lung cancer versus chemotherapy as a first-line treatment.
Crizotinib in patients with anaplastic lymphoma kinase-positive advanced non-small cell lung cancer versus chemotherapy as a first-line treatment.
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克唑替尼治疗间变性淋巴瘤激酶阳性晚期非小细胞肺癌患者与化疗作为一线治疗的比较
DOI：
10.1186/s12885-017-3720-8
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发表时间：
2018-01-03
期刊：
影响因子：
3.8
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Zhou J;Zheng J;Zhang X;Zhao J;Zhu Y;Shen Q;Wang Y;Sun K;Zhang Z;Pan Z;Shen Y;Zhou J
比较克唑替尼、培美曲塞和其他化疗方案在真实的临床应用中作为间变性淋巴瘤激酶（ALK）阳性非小细胞肺癌（NSCLC）患者一线治疗的疗效，并评价克唑替尼疗效的临床预测因素。73例ALK阳性晚期NSCLC患者根据一线治疗分为3组：一线克唑替尼组（1-CRZ组，n = 32）;一线含铂培美曲塞治疗组（1-PP组，n = 28）;一线化疗含铂非培美曲塞组（N1-PP组，n = 12）。73例患者中有68例在我院接受克唑替尼治疗并随访。比较各组客观缓解率（ORR）、疾病控制率（DCR）和无进展生存期（PFS）的差异。采用Kaplan-Meier生存分析和考克斯比例风险模型评价临床因素对克唑替尼疗效的预测作用。1-CRZ组的PFS、ORR和DCR分别为16.1个月、78.1%（25/32）和100%（32/32）; 1-PP组分别为6.0个月、17.9%（5/28）和57.2%（16/28）; N1-PP组分别为2.9个月、15.4%（2/13）和46.2%（6/13）。1-CRZ组的PFS显著长于1-PP组（P < 0.001）和N1-PP组（P < 0.001）。1-CRZ组的ORR和DCR显著高于1-PP组和N1-PP组（均P < 0.001）。美国东部肿瘤协作组（ECOG）体力状态评分（> = 2）（HR 2.345，95% CI 1.137-4.834，P = 0.021）和N1-PP化疗后接受克唑替尼治疗的患者（HR 2.345，95% CI 1.137-4.834，P = 0.021）是克唑替尼治疗后PFS较短的两个相关因素。在既往未接受过治疗的ALK阳性NSCLC患者中，克唑替尼的PFS更长、ORR和DCR更高，上级标准化疗。较高的ECOG评分（> = 2）和N1-PP化疗后接受克唑替尼治疗的患者预测克唑替尼疗效较差。
To compare the efficacy of crizotinib, pemetrexed and other chemotherapy regimens as a first-line treatment in patients with anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer (NSCLC) in real world clinical use and to evaluate the +86–571-87,236,876 predictive clinical factors of the efficacy of crizotinib. The 73 patients with ALK-positive advanced NSCLC were divided into three groups based on the first-line treatment: first-line crizotinib group (1-CRZ group, n = 32); first-line platinum-based pemetrexed treatment group (1-PP group, n = 28), and first-line chemotherapy platinum-based non-pemetrexed group (N1-PP, n = 12). Sixty eight of the 73 patients received crizotinib treatment and followed up in our hospital. Differences in the objective response rate (ORR), disease control rate (DCR) and progression-free survival (PFS) were compared in the different groups. The clinical factors were evaluated to predict the efficacy of crizotinib by the Kaplan–Meier survival analysis and Cox proportional hazards model. The PFS, ORR, DCR were 16.1 months, 78.1% (25/32) and 100% (32/32) in the 1-CRZ group; were 6.0 months, 17.9% (5/28) and 57.2% (16/28) in the 1-PP group; and were 2.9 months, 15.4% (2/13) and 46.2% (6/13) in the N1-PP group. The PFS of the 1-CRZ group was significantly longer than that of the 1-PP group (P < 0.001) and the N1-PP group (P < 0.001). The ORR and DCR of the 1-CRZ group was significantly greater than that of the 1-PP group and the N1-PP group (all the P < 0.001). Higher Eastern Cooperative Oncology Group (ECOG) performance status score (> = 2) (HR 2.345, 95% CI 1.137–4.834, P = 0.021) and patients received crizotinib after N1-PP chemotherapy (HR 2.345, 95% CI 1.137–4.834, P = 0.021) were two factors associated with shorter PFS after crizotinib treatment. In patients with ALK-positive NSCLC who did not receive previous treatment, crizotinib was superior to standard chemotherapy for the longer PFS and greater ORR and DCR. Higher ECOG score (> = 2) and patients received crizotinib after N1-PP chemotherapy predict poor efficacy of crizotinib.
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