PO.CL01.05 · 临床研究

指导EGFR突变型NSCLC患者EGFR-TKI后续治疗策略的临床生物标志物回顾性研究

Retrospective study for clinical biomarkers to guide post-EGFR-TKI treatment strategies in EGFR-mutant NSCLC

编号 5238 展板 4 时间 4/21 09:00–12:00 区域 Section 42 主讲 Tadaaki Yamada, MD;PhD

分会场 Biomarkers Predictive of Therapeutic Benefit 5

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作者与单位 Authors & Affiliations

Tadaaki Yamada¹, Kenji Morimoto¹, Naoki Furuya², Hisashi Tanaka³, Akihiro Yoshimura⁴, Tomohiro Oba⁵, Makoto Hibino⁶, Takahito Fukuda⁷, Yasuhiro Goto⁸, Akira Nakao⁹, Shinsuke Ogusu¹⁰, Yuta Okazaki¹¹, Taishi Harada¹², Takayo Ota¹³, Ken Masubuchi¹⁴, Tae Hata¹⁵, Koji Mikami¹⁶, Shoki Matsumoto¹⁷, Ryoichi Honda¹⁸, Koji Date¹⁹, Yusuke Chihara²⁰, Koichi Takayama¹

¹Kyoto Prefectural University of Medicine, Kyoto, Japan,²St. Marianna University School of Medicine, Kanagawa, Japan,³Hirosaki University Graduate School of Medicine, Hirosaki, Japan,⁴Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan,⁵Saitama Red Cross Hospital, Saitama, Japan,⁶Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan,⁷Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan,⁸Fujita Health University School of Medicine, Toyoake, Japan,⁹Fukuoka University Hospital, Fukuoka, Japan,¹⁰Saga University, Saga, Japan,¹¹Kansai Medical University, Osaka, Japan,¹²Fukuchiyama City Hospital, Fukuchiyama, Japan,¹³Izumi City General Hospital, Izumi, Japan,¹⁴Gunma Prefectural Cancer Center, Ota, Japan,¹⁵Rakuwakai Otowa Hospital, Kyoto, Japan,¹⁶Hyogo Medical University, School of Medicine, Nishinomiya, Japan,¹⁷Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan,¹⁸Kokuho Asahi Chuo Hospital, Asahi, Japan,¹⁹Kyoto Chubu Medical Center, Nantan, Japan,²⁰Uji-Tokushukai Medical Center, Uji, Japan

摘要 Abstract

中文摘要

背景:在携带表皮生长因子受体(EGFR)突变的非小细胞肺癌(NSCLC)患者中,atezolizumab、bevacizumab、carboplatin和paclitaxel的联合方案(ABCP)在既往接受EGFR酪氨酸激酶抑制剂(EGFR-TKIs)治疗后显示出令人鼓舞的疗效。然而,比较ABCP与标准铂类化疗的真实世界证据仍不明确。方法:我们开展了一项多中心回顾性研究,纳入了408例晚期或复发性EGFR突变型NSCLC患者,这些患者在日本20家机构接受EGFR-TKI治疗后接受了铂类化疗(联合或不联合bevacizumab)或ABCP治疗。使用倾向性评分匹配来调整基线特征,以评估临床结局。结果:经过倾向性评分匹配后,Chemo/Chemo + BEV组与ABCP组在无进展生存期(PFS)或总生存期(OS)方面无显著差异(中位PFS,p = 0.44;中位OS,p = 0.84)。在程序性死亡配体1(PD-L1)表达≥50%的亚组中,ABCP组的PFS显著长于Chemo/Chemo + BEV组(p = 0.02)。结论:在既往接受EGFR-TKIs治疗的EGFR突变型NSCLC患者中,PD-L1高表达的患者可能从ABCP治疗中获得比铂类化疗更大的获益,提示ABCP在该亚组中可能是一种更有前景的治疗选择。

查看英文原文 English abstract

Background: In patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations, the combination of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) has demonstrated encouraging efficacy following prior treatment with EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, real-world evidence comparing ABCP with standard platinum-based chemotherapy remains unclear. Methods: We conducted a multicenter retrospective study including 408 patients with advanced or recurrent EGFR-mutant NSCLC who received either platinum-based chemotherapy (with or without bevacizumab) or ABCP after EGFR-TKI treatment at 20 institutions in Japan. Clinical outcomes were evaluated using propensity score matching to adjust for baseline characteristics. Results: After propensity score matching, there were no significant differences in progression-free survival (PFS) or overall survival (OS) between the Chemo/Chemo + BEV and ABCP groups (median PFS, p = 0.44; median OS, p = 0.84). In the subgroup of patients with programmed death-ligand 1 (PD-L1) expression ≥50%, the ABCP group exhibited significantly longer PFS compared with the Chemo/Chemo + BEV group ( p = 0.02). Conclusions: Among patients with EGFR-mutant NSCLC previously treated with EGFR-TKIs, those with high PD-L1 expression may derive greater benefit from ABCP therapy compared with platinum-based chemotherapy, suggesting that ABCP could represent a more promising treatment option in this subgroup.

利益披露 Disclosure

T. Yamada, Eli Lilly ). Taiyo Kagaku Co.,Ltd. ). N. Furuya, None.. H. Tanaka, None.. A. Yoshimura, None.. T. Oba, None.. M. Hibino, None.. T. Fukuda, None.. Y. Goto, None.. A. Nakao, None.. S. Ogusu, None.. Y. Okazaki, None.. T. Harada, None.. K. Masubuchi, None.. T. Hata, None.. K. Mikami, None.. S. Matsumoto, None.. R. Honda, None.. K. Date, None.. Y. Chihara, None.. K. Takayama, None.

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