机构：[1]Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China四川大学华西医院[2]Department of Thoracic Cancer, Medical Oncology Center, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China四川省人民医院四川省肿瘤医院[3]Department of Thoracic Oncology, The Second People’s Hospital of Yibin, Yibin, China[4]Department of Oncology, Cancer Center, Affiliated Hospital of North Sichuan Medical College, Nan Chong, China[5]Department of Oncology, The First People’s Hospital of Neijiang, Neijiang, China[6]Department of Oncology and Hematology, Leshan People’s Hospital, Leshan, China[7]Cancer Center, Suining Central Hospital, Suining, China
BackgroundData on the use of immune checkpoint inhibitors (ICIs) in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation are limited. The current study aimed to assess the efficacy of ICIs in EGFR-mutant advanced NSCLC and explore the relevant influential factors. Materials and MethodsRelevant clinical data of EGFR-mutant NSCLC patients who had received ICIs were collected from multiple hospitals. The primary endpoint was progression-free survival (PFS), and the secondary endpoints were overall survival (OS), objective response rate (ORR), and relevant influential factors. ResultsA total of 122 advanced EGFR-mutant NSCLC patients were included in the final analysis. The total cohort had an objective response rate (ORR) of 32.0%, a median progression-free survival (mPFS) of 5.0 months, and a median overall survival (mOS) of 14.4 months. Among 96 patients with common EGFR mutations (19Del, 52 patients; L858R, 44 patients), those who were administered front-line ICI exhibited better survival benefits than those who received later-line ICI after disease progression on tyrosine kinase inhibitors (TKIs) treatment (mPFS: 7.2 months vs. 3.4 months, respectively, P < 0.0001; mOS: 15.1 months vs. 8.4 months, respectively, P <0.0001). Moreover, the efficacy of ICI-based combination therapy was better than that of ICI monotherapy (mPFS: 5.0 months vs. 2.2 months, respectively, P = 0.002; mOS: 14.4 months vs. 7.0 months, respectively, P = 0.001). Multivariate analysis showed that ICI-based combination therapy and front-line ICI administration after progression on EGFR-TKI were associated with significant improvements in both PFS and OS (P < 0.05). A high PD-L1 expression (tumor proportion score, TPS >= 50%) and the EGFR L858R mutation were only significantly associated with a better PFS (P <0.05). A better Eastern Cooperative Oncology Group (ECOG) status was independently associated with a favorable OS (P <0.05). ConclusionsTaken together, combination immunotherapy in front-line was associated with improvement of survival in EGFR-mutant NSCLC patients post-TKI resistance. Further prospective studies with large sample sizes are required to identify the optimal combinatorial treatment strategy.
第一作者机构：[1]Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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推荐引用方式(GB/T 7714)：
Tian Tian,Yu Min,Li Juan,et al.Front-Line ICI-Based Combination Therapy Post-TKI Resistance May Improve Survival in NSCLC Patients With EGFR Mutation[J].FRONTIERS IN ONCOLOGY.2021,11:doi:10.3389/fonc.2021.739090.
APA：
Tian, Tian,Yu, Min,Li, Juan,Jiang, Maoqiong,Ma, Daiyuan...&Lu, You.(2021).Front-Line ICI-Based Combination Therapy Post-TKI Resistance May Improve Survival in NSCLC Patients With EGFR Mutation.FRONTIERS IN ONCOLOGY,11,
MLA：
Tian, Tian,et al."Front-Line ICI-Based Combination Therapy Post-TKI Resistance May Improve Survival in NSCLC Patients With EGFR Mutation".FRONTIERS IN ONCOLOGY 11.(2021)
