Abstract

 

OBJECTIVES

To clarify survival outcomes and prognostic factors of patients receiving epidermal growth factor receptor (EGFR) - tyrosine kinase inhibitors (TKIs) as first-line treatment for postoperative recurrence.

METHODS

A retrospective chart review was performed to identify consecutive patients who received EGFR-TKIs as first-line treatment for postoperative recurrence of non-small-cell lung cancer (NSCLC) harbouring EGFR gene mutations at our institution between August 2002 and October 2020. Therapeutic response, adverse events, progression-free survival (PFS) and overall survival (OS) were investigated. Survival outcomes were assessed using the Kaplan–Meier analysis. The Cox proportional hazards model was used for univariable and multivariable analyses.

RESULTS

Sixty-four patients were included in the study. The objective response and disease control rates were 53% and 92%, respectively. Grade 3 or greater adverse events were noted in 4 (6.3%) patients, including 1 patient (1.6%) of interstitial pneumonia. The median follow-up period was 28.5 months (range 3–202 months). The total number of events was 43 for PFS and 23 for OS, respectively. The median PFS was 18 months, and the median OS was 61 months after EGFR-TKI treatment. In multivariable analysis, osimertinib showed a tendency to prolong PFS [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.12–1.1; P = 0.071], whereas the micropapillary component was significantly associated with shorter OS (HR 2.1, 95% CI 1.02–6.9; P = 0.045).

CONCLUSIONS

EGFR-TKIs as first-line treatment appeared to be a reasonable treatment option in selected patients with postoperative recurrent EGFR-mutated NSCLC. Osimertinib and the micropapillary component may be prognostic factors.

中文翻译：

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表皮生长因子受体 (EGFR)——酪氨酸激酶抑制剂作为术后复发和 EGFR 突变非小细胞肺癌的一线治疗

摘要

 

目标

阐明接受表皮生长因子受体 (EGFR) - 酪氨酸激酶抑制剂 (TKI) 作为术后复发一线治疗的患者的生存结果和预后因素。

方法

进行回顾性图表审查，以确定 2002 年 8 月至 2020 年 10 月期间在我们机构接受 EGFR-TKI 作为一线治疗携带 EGFR 基因突变的非小细胞肺癌 (NSCLC) 术后复发的连续患者。治疗反应、不良事件、无进展生存期（PFS）和总生存期（OS）进行了调查。使用 Kaplan-Meier 分析评估生存结果。Cox比例风险模型用于单变量和多变量分析。

结果

研究中包括了 64 名患者。客观缓解率和疾病控制率分别为 53% 和 92%。4 名 (6.3%) 患者出现 3 级或以上不良事件，包括 1 名 (1.6%) 间质性肺炎患者。中位随访期为 28.5 个月（范围 3-202 个月）。PFS 和 OS 的事件总数分别为 43 和 23。EGFR-TKI 治疗后的中位 PFS 为 18 个月，中位 OS 为 61 个月。在多变量分析中，奥希替尼显示出延长 PFS 的趋势 [风险比 (HR) 0.41，95% 置信区间 (CI) 0.12–1.1；P  = 0.071]，而微乳头成分与较短的 OS 显着相关（HR 2.1，95% CI 1.02–6.9；P  = 0.045）。

结论

EGFR-TKI 作为一线治疗似乎是选定的术后复发 EGFR 突变 NSCLC 患者的合理治疗选择。奥希替尼和微乳头成分可能是预后因素。