表皮生长因子受体突变晚期非小细胞肺癌患者一代酪氨酸激酶抑制剂序贯奥希替尼治疗疗效分析

Sequential treatment with first-generation tyrosine kinase inhibitor and osimertinib in patients with EGFR mutation-positive advanced non-small-cell lung cancer

目的分析一代表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor tyrosine kinase inhihitor,ECFRTKI)序贯奥希替尼治疗EGFR突变阳性晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效。方法选取2010年3月-2018年11月在解放军总医院行TKI序贯奥希替尼治疗的晚期NSCLC患者99例,男37例,女62例,平均年龄56(28~80)岁。分析患者的基本特征、疾病特点、治疗经过及生存情况,评价治疗效果。结果99例使用一代TKI序贯奥希替尼治疗的总中位无进展生存期(progression-free survival,PFS)为26.4个月(95%CI:23.1~29.6),客观缓解率为62.6%。使用一代TKI治疗时间>10.1个月的患者,序贯奥西替尼治疗的PFS显著延长(16.4个月vs 7.1个月,P=0.004)。结论一代TKI治疗时间>10.1个月的患者,序贯奥西替尼治疗的PFS长于一代TKI治疗时间小于10.1个月的患者。

Objective To analyze the effectiveness of sequential first-generation tyrosine kinase inhibitor(TKI)and osimertinib on epidermal growth factor receptor(EGFR)mutation-positive advanced non-small-cell lung cancer.Methods A total of 99 patients with EGFR mutation-positive non-small cell lung cancer(NSCLC)treated with sequential first-generation epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)and osimertinib in the first medical center of Chinese PLA General Hospital from March 2010 to November 2018 were enrolled.There were 37 males and 62 females with an average age of 56(28-80)years.The patients’ basic characteristics,disease characteristics,treatment and survival were analyzed,and the treatment effect was evaluated.Results The median progression-free survival(PFS)of 99 patients was 26.4 months(95% confidence interval:23.1 to 29.6),and the objective response rate(ORR)was 62.6%.Patients treated with first-generation TKI for more than 10.1 months had a significant prolongation of PFS after sequential osimertinib treatment(16.4 months v.s 7.1 months,P=0.004).Conclusion The PFS of patients treated with first-generation TKI for more than 10.1 months following osimertinib is longer than patients with first-generation TKI treated ≤ 10.1 months.