| 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 | Analysis of Poor Prognostic Factors and Treatment Strategies in Platinum-Based Systemic Therapy After EGFR-TKI Failure in Patients With Advanced Nonsmall Cell Lung Cancer Harboring EGFR Mutations. |
| 掲載誌名 | 正式名：Clinical lung cancer 略 称：Clin Lung Cancer ISSNコード：19380690/15257304 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 26(8),pp.e639-e648 |
| 著者・共著者 | Tae Hata, 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, Shoki Matsumoto, Ryoichi Honda, Koji Date, Yusuke Chihara, Hayato Kawachi, Kenji Morimoto, Koichi Takayama |
| 発行年月 | 2025/12 |
| 概要 | BACKGROUND:The aim of this study was to identify poor prognostic factors and explore optimal second-line treatment strategies for patients with epidermal growth factor receptor (EGFR)-mutant nonsmall cell lung cancer (NSCLC) who developed resistance to EGFR tyrosine kinase inhibitors (TKIs).PATIENTS AND METHODS:We retrospectively evaluated patients with advanced or recurrent EGFR-mutant NSCLC who received platinum-based systemic therapy after EGFR-TKI failure from January 2017 to July 2022 at 20 institutions. Logistic regression analysis was used to identify factors associated with 1-year mortality after the start of systemic therapy.RESULTS:We included 393 patients in the final analysis (101 received atezolizumab, bevacizumab, carboplatin, and paclitaxel [ABCP], 292 received chemotherapy); 143 (36.3%) had an overall survival (OS) <1 year. Compared to the group with OS ≥1 year, the group with OS <1 year had significantly higher rates of performance status (PS) 2-4 and brain, liver, and bone metastases. Multivariable analysis revealed that PS ≥2, bone metastasis, and failure to respond to pretreatment EGFR-TKI were associated with poor OS. ABCP had numerical, but not statistically significant, OS improvement versus chemotherapy in patients with at least 1 poor prognostic factor (P = .079). Among patients with bone metastases (48.3%, n = 190), those treated with ABCP had a significantly longer median OS than those treated with chemotherapy (P = .032).CONCLUSION:EGFR-mutant NSCLC with PS ≥2 or bone metastases was associated with a poor prognosis after EGFR-TKI failure. Patients with poor prognostic factors, especially bone metastases, may benefit more from ABCP than from chemotherapy. |
| DOI | 10.1016/j.cllc.2025.07.014 |
| PMID | 40816949 |