EGFR-TKI is effective regardless of treatment timing in pulmonary adenocarcinoma with EGFR mutation
EGFR-TKI is effective regardless of treatment timing in pulmonary adenocarcinoma with EGFR mutation
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DOI：
10.1007/s00280-014-2631-5
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发表时间：
2015-01-01
影响因子：
3
通讯作者：
Kim, Sang-We
中科院分区：
文献类型：
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作者：
Koo, Dong-Hoe;Kim, Kyu-pyo;Kim, Sang-We
2006年3月至2010年5月，在同一家研究机构共对1,250例NSCLC患者进行EGFR突变筛查。根据治疗时间比较EGFR-TKI在缓解率（RR）、无进展生存期（PFS）和总生存期（OS）方面的疗效。在437例（36.1%）EGFR突变患者中，我们分析了222例接受EGFR-TKI治疗的患者。中位随访持续时间为27.5个月（范围8.3-69.2），分别有97例（43.7%）、109例（49.1%）和16例（7.2%）患者接受了EGFR-TKI一线、二线和三线治疗。所有三组均显示与EGFR-TKI相似的RR（分别为71.1、72.5和75.0%）（p = 0.802）。根据EGFR-TKI的治疗时间，在PFS（中位数10.6、13.0和10.4个月; p = 0.670）和OS（中位数20.5、26.2和17.1个月; p = 0.142）方面未观察到显著差异。在调整了包括性能、疾病状态和EGFR突变类型在内的重要预后因素后，EGFR-TKI的治疗时间仍然显示与PFS或OS无关。无论治疗时间如何，EGFR-TKI在EGFR突变阳性腺癌患者中的RR、PFS和OS方面均显示出相似的疗效。尽管EGFR-TKI目前是EGFR阳性肿瘤患者的一线治疗选择，但当无法在短时间内获得EGFR突变状态时，EGFR-TKI序贯治疗可能是合理的选择。
Although epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have become key therapeutic agents for non-small cell lung cancer (NSCLC) patients with EGFR mutation, little is known about the efficacy of EGFR-TKIs according to different treatment timings.A total of 1,250 patients with NSCLC were screened for EGFR mutations at a single institution between March 2006 and May 2010. The efficacy of EGFR-TKIs in terms of response rate (RR), progression-free survival (PFS), and overall survival (OS) were compared according to the treatment timing.Among the 437 patients (36.1 %) with EGFR mutation, we analyzed 222 patients who received EGFR-TKI treatment. With a median follow-up duration of 27.5 months (range 8.3-69.2), EGFR-TKI was given to 97 (43.7 %), 109 (49.1 %), and 16 (7.2 %) patients as first-line, second-line, and third-line therapy, respectively. All three groups showed similar RR (71.1, 72.5, and 75.0 %, respectively) to EGFR-TKI (p = 0.802). No significant difference was observed according to treatment timing of EGFR-TKI in terms of PFS (median 10.6, 13.0, and 10.4 months; p = 0.670) and OS (median 20.5, 26.2, and 17.1 months; p = 0.142). The treatment timing of EGFR-TKI still showed no association with PFS or OS after adjusting significant prognostic factors including performance, disease status, and EGFR mutation types.EGFR-TKIs showed similar efficacy in patients with EGFR mutation-positive adenocarcinoma in terms of RR, PFS, and OS irrespective of treatment timing. Although EGFR-TKIs are currently the treatment of choice of first-line treatment in patients with EGFR-positive tumors, the sequential treatment with EGFR-TKI could be a reasonable option when EGFR mutation status cannot be obtained in a short time.