Background and objective: The epidermal growth factor receptor tyrosine kinase inhibitor (EGFRTKI) shows favorable antitumor activity against chemorefractory non-small cell lung cancer (NSCLC). However, patients with advanced NSCLC have limited treatment options available if they are refractory to EGFR-TKI. To study the influence of the retreatment EGFR-TKI after failure of first-line TKI, we carried out this retrospective study.
Methods: Total 71 patients were analyzed who experienced treatment failure from their initial use of EGFR-TKI. After a period of time, they were retreated with TKI as tumor progression was observed.
Results: Of the 71 patients who received retreatment TKI, it was observed in 7% in partial response (PR), 36.6% in stable disease (SD), 56.3% in progressive disease (PD). Disease control rate (DCR) was 43.7%. Twenty-six (36.6%) patients were well controlled by retreatment with TKI monotherapy for not less than 3 months. Five (7.0%) patients had partial response. Exon 21 mutation, PFS not less than 6 months during initial treatment TKI, and the interval not less than 3 months between initial treatment, and retreatment with TKI was associated with a good progression free survival based on univariate COX analysis (P=0.034; P=0.013; P=0.046).
Conclusions: It has been shown the possibility that retreatment with TKI might be useful when (1) Exon 21 has active mutation, (2) initial treatment shows a favorable PFS (≥ 6 months), and (3) there has been a period of time (≥3 months) following the termination of the initial TKI treatment.
背景与目的: 表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor tyrosine kinase inhibitor, EGFR-TKI）是化疗失败的晚期非小细胞肺癌（non-small cell lung cancer, NSCLC）的标准二三线治疗方案，亦是EGFR突变患者一线治疗的最佳选择，但对初始治疗后进展的患者，在治疗过程中能否再次使用TKI是目前的关注热点。本研究旨在探讨晚期NSCLC初始治疗后再次应用EGFR-TKI的疗效。
方法: 本研究回顾性分析了71例晚期或术后复发的NSCLC初始EGFR-TKI治疗后，再次应用TKI的疗效。
结果: 71例再次应用TKI的患者中，部分缓解（partial response, PR）为7%，稳定（stable disease, SD）为36.6%，（progressive disease, PD）为56.3%，疾病控制率（disease contral rate, DCR）为43.7%，无进展生存期（progression free survival, PFS） > 3个月者26例（36.6%）。EGFR 21外显子突变、初始TKI缓解期≥6个月、两次TKI的间隔期≥3个月与更长的PFS相关，单因素COX回归分析，P值分别为0.034、0.013、0.046。
结论: TKI治疗失败的NSCLC患者再次应用TKI，部分患者仍可获得疾病控制。EGFR 21外显子突变、初始TKI缓解期≥6个月、两次TKI间隔期≥3个月的患者更可能从再次应用TKI中获益。