| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Impact of EGFR Mutation Subtypes on Response to Chemoimmunotherapy and Chemotherapy in Non-Small-Cell Lung Cancer After EGFR-TKI Failure. |
| 掲載誌名 | 正式名：Targeted oncology 略 称：Target Oncol ISSNコード：1776260X/17762596 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 20(3),pp.531-541 |
| 著者・共著者 | Kenji Morimoto, Tadaaki Yamada, Naoki Furuya, Hisashi Tanaka, Akihiro Yoshimura, Tomohiro Oba, Makoto Hibino, Takahito Fukuda, Yasuhiro Goto, Akira Nakao, Shinsuke Ogusu, Yuta Okazaki, Taishi Harada, Takayo Ota, Ken Masubuchi, Koji Mikami, Tae Hata, Shoki Matsumoto, Ryoichi Honda, Koji Date, Yusuke Chihara, Hayato Kawachi, Koichi Takayama |
| 発行年月 | 2025/05 |
| 概要 | BACKGROUND:The efficacy of immune checkpoint inhibitor (ICI) monotherapy on non-small-cell lung cancer (NSCLC) varies by epidermal growth factor receptor (EGFR) mutation subtypes. However, the impact of these subtypes on the clinical outcomes of chemoimmunotherapy (Chemo+ICI) or platinum-based chemotherapy (Chemo) in real-world practice remains unclear.OBJECTIVE:This study evaluated the impact of EGFR mutation subtypes on NSCLC treatment outcomes of Chemo and Chemo+ICI.PATIENTS AND METHODS:We retrospectively analyzed patients with advanced or recurrent EGFR-mutant NSCLC from 20 institutions between January 2017 and July 2022. Patients received Chemo with or without ICI after failure of EGFR-tyrosine kinase inhibitors. Common EGFR mutations were categorized as exon 19 deletions and exon 21 L858R mutations.RESULTS:Among the 403 patients, 205 (50.9%) had exon 19 deletions, and 198 (49.1%) had L858R mutations. For patients with L858R mutations, Chemo+ICI significantly improved progression-free survival (PFS) compared with Chemo (7.0 vs 5.3 months; p = 0.04). However, no significant difference in PFS was observed between treatments for patients with exon 19 deletions (6.7 vs 6.0 months; p = 0.96). Multivariate analysis identified Chemo+ICI as an independent predictor of PFS in patients with L858R mutations (hazard ratio 0.63; 95% confidence interval 0.43-0.92; p = 0.02).CONCLUSIONS:Among patients with common EGFR mutation subtypes, those with L858R mutations demonstrated significantly improved PFS with Chemo+ICI than with Chemo. These findings suggest that Chemo+ICI may offer a more effective treatment option for patients with L858R-mutant NSCLC, warranting further investigation in prospective studies. |
| DOI | 10.1007/s11523-025-01144-6 |
| PMID | 40274716 |