Gender and outcomes in non-small cell lung cancer: an old prognostic variable comes back for targeted therapy and immunotherapy?
Gender and outcomes in non-small cell lung cancer: an old prognostic variable comes back for targeted therapy and immunotherapy?
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DOI：
10.1136/esmoopen-2018-000344
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发表时间：
2018
期刊：
影响因子：
7.3
通讯作者：
Rolfo C
中科院分区：
文献类型：
--
作者：
Pinto JA;Vallejos CS;Raez LE;Mas LA;Ruiz R;Torres-Roman JS;Morante Z;Araujo JM;Gómez HL;Aguilar A;Bretel D;Flores CJ;Rolfo C
非小细胞肺癌 (NSCLC) 和其他癌症的性别结局存在众所周知的差异。在这项工作中，我们评估了几项随机临床试验，以探讨性别对接受靶向治疗和免疫治疗的 NSCLC 患者预后的影响。我们进行了一系列荟萃分析，以比较 EGFR 抑制剂与化疗（OPTIMAL、LUX-lung 3、LUX-lung 6、EURTAC、ENSURE 和 WTJOG）进行比较的 III 期随机临床试验中常规环境下总生存期和无进展生存期 (PFS) 的性别结果； ALK 抑制剂与化疗（ASCEND 4、ASCEND 5、PROFILE 1014 和 NCT009323893）以及抗 PD1 检查点抑制剂与化疗（CheckMate 017、CheckMate 026、CheckMate 057、KEYNOTE 010 和 KEYNOTE 024）的比较。与男性相比，女性 NSCLC 患者的死亡风险较低（HR=0.73；95%CI 0.67 至 0.79；p<0.00001）。女性从 EGFR 抑制剂中获益比男性更好（HR=0.34；95%CI 0.28 至 0.40；p<0.00001 vs HR=0.44；95%CI 0.34 至 0.56；p<0.00001）。 ALK 抑制剂的获益对两性相似（女性和男性分别为 HR=0.51；95%CI 0.42 至 0.61；p<0.00001 vs HR=0.48；95%CI 0.39 至 0.59；p<0.00001）。与化疗相比，抗 PD1 抑制剂显着改善男性患者的 PFS（HR=0.76；95%CI 0.68 至 0.86；p<0.00001）；相比之下，女性在 5/5 随机试验中没有表现出任何获益（HR=1.03；95%CI 0.89 至 1.20；p=0.69）。在这项探索性研究中，一些针对性治疗受到性别的影响。尽管不同的组织学、EGFR 和吸烟状况可能导致结果存在差异，但性别应作为 NSCLC 患者的预后变量进行更深入的评估。
There are well-known differences in gender outcome in non-small cell lung cancer (NSCLC) and other cancers. In this work, we evaluated several randomised clinical trials to explore the gender influence in the outcome of patients with NSCLC treated with targeted therapy and immunotherapy. We performed a series of meta-analysis to compare the gender outcome in the routine setting for overall survival and progression-free survival (PFS) in phase III randomised clinical trials comparing EGFR inhibitors versus chemotherapy (OPTIMAL, LUX-lung 3, LUX-lung 6, EURTAC, ENSURE and WTJOG); ALK inhibitors versus chemotherapy (ASCEND 4, ASCEND 5, PROFILE 1014 and NCT009323893) and anti-PD1 checkpoint inhibitors versus chemotherapy (CheckMate 017, CheckMate 026, CheckMate 057, KEYNOTE 010 and KEYNOTE 024). Female patients with NSCLC have a reduced risk of death compared with men (HR=0.73; 95% CI 0.67 to 0.79; p<0.00001). Women had a better benefit from EGFR inhibitors than men (HR=0.34; 95% CI 0.28 to 0.40; p<0.00001 vs HR=0.44; 95% CI 0.34 to 0.56; p<0.00001, respectively). The benefit from ALK inhibitors was similar for both genders (HR=0.51; 95% CI 0.42 to 0.61; p<0.00001 vs HR=0.48; 95% CI 0.39 to 0.59; p<0.00001, for women and men, respectively). Anti-PD1 inhibitors significantly improved the PFS in male patients when compared with chemotherapy (HR=0.76; 95% CI 0.68 to 0.86; p<0.00001); in contrast, women showed no benefit in 5/5 randomised trials (HR=1.03; 95% CI 0.89 to 1.20; p=0.69). In this exploratory study, some targeted treatments were influenced by gender. Despite differences in outcomes that could be attributed to different histology, EGFR and smoking status, gender should be evaluated more deeply as prognostic variable in patients with NSCLC.
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影响因子：
10.1
作者：
Johnson DB;Frampton GM;Rioth MJ;Yusko E;Xu Y;Guo X;Ennis RC;Fabrizio D;Chalmers ZR;Greenbowe J;Ali SM;Balasubramanian S;Sun JX;He Y;Frederick DT;Puzanov I;Balko JM;Cates JM;Ross JS;Sanders C;Robins H;Shyr Y;Miller VA;Stephens PJ;Sullivan RJ;Sosman JA;Lovly CM
通讯作者：
Lovly CM
癌症死亡率和生存中的性别差异。
DOI：
10.1158/1055-9965.epi-11-0246
发表时间：
2011-08
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Cook MB;McGlynn KA;Devesa SS;Freedman ND;Anderson WF
通讯作者：
Anderson WF
影响因子：
9.6
作者：
Meguid, Robert A.;Hooker, Craig M.;Brock, Malcolm V.
通讯作者：
Brock, Malcolm V.
影响因子：
2.9
作者：
Fan H;Shao ZY;Xiao YY;Xie ZH;Chen W;Xie H;Qin GY;Zhao NQ
通讯作者：
Zhao NQ
影响因子：
4
作者：
Egleston BL;Meireles SI;Flieder DB;Clapper ML
通讯作者：
Clapper ML