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BMJ:一线非小细胞肺癌靶向疗法临床疗效比较研究

2019-10-08 MedSci MedSci原创

吉非替尼+培美曲塞为基础化疗以及奥西替尼治疗可最大程度的改善EGFR突变型晚期非小细胞肺癌患者无进展生存期和总生存期

近日研究人员开展系统综述及荟萃分析研究,比较一线晚期表皮生长因子受体(EGFR)突变型非小细胞肺癌(NSCLC)疗法的疗效和安全性差异。

收集截至2019年5月20日的相关研究,主要终点包括无进展生存率、总生存率、客观反应率和3级以上不良事件。

18个临床研究,总计包含4628名患者,总计12种疗法:EGFR酪氨酸激酶抑制剂(TKI;奥西替尼、达克替尼、阿法替尼、厄洛替尼、吉非替尼和埃克替尼)、基于培美曲塞的化疗、无培美曲塞化疗和联合治疗(阿法替尼+西妥昔单抗、厄洛替尼+贝伐昔单抗、吉非替尼+培美曲塞为基础化疗以及吉非替尼+培美曲塞)。以吉非替尼联合培美曲塞为基础化疗为标准,奥西替尼对患者无进展生存期改善效果与吉非替尼联合培美曲塞为基础化疗一致(HR=0.95),而其他疗法效果较低,且差异较显著,其中达克替尼为0.74、阿法替尼为0.52、厄洛替尼为0.48、吉非替尼为0.44、埃克替尼为0.39、培美曲塞化疗为0.24、无培美曲塞化疗为0.16、阿法替尼+西妥昔单抗为0.44、吉非替尼+培美曲塞为0.65。奥西替尼与吉非替尼联合培美曲塞为基础化疗对患者总生存期的改善效果一致,且最为显著(HR=0.94)。联合治疗导致的毒性比较常见,特别是厄洛替尼+贝伐昔单抗疗法。亚组分析显示,奥西替尼与19外显子缺失患者的最佳无进展生存有关,而吉非替尼+培美曲塞为基础化疗与Leu858Arg突变患者的最佳无进展生存有关。

研究发现,吉非替尼+培美曲塞为基础化疗以及奥西替尼治疗可最大程度的改善EGFR突变型晚期非小细胞肺癌患者无进展生存期和总生存期。

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    2020-06-28 gaoxiaoe
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    2019-10-08 404978306_75611995

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1848864, encodeId=e4bc18488647c, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Sun Jun 28 22:04:00 CST 2020, time=2020-06-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1907196, encodeId=90bf190e19690, content=<a href='/topic/show?id=acc02289e40' target=_blank style='color:#2F92EE;'>#临床疗效#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22897, encryptionId=acc02289e40, topicName=临床疗效)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8346212, createdName=respect, createdTime=Thu Jun 11 15:04:00 CST 2020, time=2020-06-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2059838, encodeId=d90a2059838ef, content=<a href='/topic/show?id=2cc599381bd' target=_blank style='color:#2F92EE;'>#非小细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99381, encryptionId=2cc599381bd, topicName=非小细胞)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e07307, createdName=lingaifan, createdTime=Sat Apr 11 06:04:00 CST 2020, time=2020-04-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1378545, encodeId=b77913e8545f4, content=<a href='/topic/show?id=2cf09992871' target=_blank style='color:#2F92EE;'>#靶向疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99928, encryptionId=2cf09992871, topicName=靶向疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b676418, createdName=yanghan, createdTime=Thu Oct 10 10:04:00 CST 2019, time=2019-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=373673, encodeId=38e73e36734e, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5caf5181166, createdName=404978306_75611995, createdTime=Tue Oct 08 22:50:04 CST 2019, time=2019-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032302, encodeId=69ac10323025a, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Tue Oct 08 22:04:00 CST 2019, time=2019-10-08, status=1, ipAttribution=)]
    2019-10-08 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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