医学
克里唑蒂尼
内科学
肿瘤科
危险系数
肺癌
腺癌
比例危险模型
对数秩检验
吉西他滨
非小细胞肺癌
队列
阶段(地层学)
癌症
置信区间
生物
A549电池
古生物学
恶性胸腔积液
作者
Mark M. Awad,Giulia Costanza Leonardi,Sasha Kravets,Suzanne E. Dahlberg,Alexander Drilon,Sinead A. Noonan,D. Ross Camidge,Sai-Hong Ignatius Ou,Daniel B. Costa,Shirish M. Gadgeel,Conor E. Steuer,Patrick M. Forde,Viola W. Zhu,Yoko Korenaga Fukuda,Jeffrey W. Clark,Pasi A. Jänne,Tony Mok,Lynette M. Sholl,Rebecca S. Heist
标识
DOI:10.1200/jco.2017.35.15_suppl.8511
摘要
8511 Background: Dramatic responses to MET inhibitors have been reported in patients with NSCLC harboring activating mutations that cause MET exon 14 ( METdel14) skipping. We conducted a multicenter retrospective analysis of pts with METdel14 NSCLC to determine if treatment with MET inhibitors impacts survival. Methods: We collected clinicopathologic data on pts with METdel14 NSCLC. Event-time distributions were estimated using Kaplan-Meier and compared with the log-rank test. Multivariable Cox models were fitted to estimate hazard ratios. Results: Of the 148 pts with METdel14 mutant NSCLC, the median age was 72 (range 43-88); 57% were women, and 41% were never smokers. The most common histologies were adenocarcinoma (77%) and pulmonary sarcomatoid carcinoma (14%). Overlap with oncogenic driver mutations in other genes was rare. At the time of diagnosis, 70% of pts had stage I-III disease, and 30% had stage IV disease. Of the 34 pts with metastastic disease who never received a MET inhibitor, the median overall survival (mOS) was 8.1 months. In this cohort, cancers that also had concurrent MET amplification had a trend toward worse survival compared to cancers without MET amplification (5.2 months vs 10.5 months, P = 0.06). Of the 27 pts with metastatic disease who received at least one MET inhibitor (including crizotinib, glesatinib, capmatinib, and ABBV-399), the mOS was 24.6 months. A model adjusting for receipt of a MET inhibitor as first- or second-line therapy as a time-dependent covariate demonstrated that treatment with a MET inhibitor was associated with a significant prolongation in survival (HR 0.11, 95% CI 0.01-0.92, P = 0.04). Among 22 patients treated with crizotinib, the median progression-free survival (PFS) was 7.36 months. Conclusions: Forpts with METdel14 NSCLC, treatment with a MET inhibitor is associated with an improvement in overall survival. The prognosis of pts who never received treatment with a MET inhibitor appears to be poor, particularly among METdel14 cancers with concurrent MET amplification.
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