Osimertinib plus local treatment for brain metastases versus osimertinib alone in patients with EGFR-Mutant Non-Small Cell Lung Cancer

奥西默替尼 医学 危险系数 肺癌 肿瘤科 内科学 无进展生存期 置信区间 回顾性队列研究 癌症 表皮生长因子受体 化疗 埃罗替尼
作者
Takehiro Tozuka,Rintaro Noro,Hideaki Mizutani,Futoshi Kurimoto,Taiki Hakozaki,Kakeru Hisakane,Tomoyuki Naito,Satoshi Takahashi,Namiko Taniuchi,Chika Yajima,Yukio Hosomi,Takashi Hirose,Yuji Minegishi,Tetsuya Okano,Koichiro Kamio,Tomoyoshi Yamaguchi,Masahiro Seike
出处
期刊:Lung Cancer [Elsevier]
卷期号:191: 107540-107540 被引量:2
标识
DOI:10.1016/j.lungcan.2024.107540
摘要

Objectives Osimertinib is a standard treatment for patients with EGFR-mutant non-small cell lung cancer (NSCLC) and is highly effective for brain metastases (BMs). However, it is unclear whether local treatment (LT) for BMs prior to osimertinib administration improves survival in EGFR-mutant NSCLC. We aimed to reveal the survival benefit of upfront local treatment (LT) for BMs in patients treated with osimertinib. Materials and Methods This multicenter retrospective study included consecutive patients with EGFR mutation (19del or L858R)-positive NSCLC who had BMs before osimertinib initiation between August 2018 and October 2021. We compared overall survival (OS) and central nervous system progression-free survival (CNS-PFS) between patients who received upfront LT for BMs (the upfront LT group), and patients who received osimertinib only (the osimertinib-alone group). Inverse-probability treatment weighting (IPTW) analysis was performed to adjust for potential confounding factors. Results Of the 121 patients analyzed, 57 and 64 patients had 19del and L858R, respectively. Forty-five and 76 patients were included in the upfront LT group and the osimertinib-alone groups, respectively. IPTW-adjusted Kaplan–Meier curves showed that the OS of the upfront LT group was significantly longer than that of the osimertinib-alone group (median, 95 % confidence intervals [95 %CI]: Not reached [NR], NR–NR vs. 31.2, 21.7–33.2; p = 0.021). The hazard ratio (HR) for OS and CNS-PFS was 0.37 (95 %CI, 0.16–0.87) and 0.36 (95 %CI, 0.15–0.87), respectively. Conclusions The OS and CNS-PFS of patients who received upfront LT for BMs followed by osimertinib were significantly longer than those of patients who received osimertinib alone. Upfront LT for BMs may be beneficial in patients with EGFR-mutant NSCLC treated with osimertinib.
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