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Efficacy analysis of immunotherapy‑based combinations for patients with EGFR‑mutant advanced non‑small cell lung cancer after TKI failure
Treatment options for epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) following tyrosine kinase inhibitor (TKI) failure are limited, and platinum-based chemotherapy remains the main treatment. The development of effective immunotherapy for this disease has...
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Published in: | Oncology letters 2024-11, Vol.28 (5), p.1, Article 504 |
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description | Treatment options for epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) following tyrosine kinase inhibitor (TKI) failure are limited, and platinum-based chemotherapy remains the main treatment. The development of effective immunotherapy for this disease has been challenging. In the present study, 37 patients with EGFR-mutant advanced NSCLC who were treated with programmed cell death-1 (PD-1) inhibitor-based combinations after TKI failure were reviewed. The total cohort had a median progression-free survival (mPFS) of 5.2 months (95% CI, 4.077-6.323 months) and a median overall survival (mOS) of 18.3 months (95% CI, 12.932-23.668 months). Patients with Eastern Cooperative Oncology Group performance-status (ECOG-PS) scores of 0 or 1 had longer mPFS than those with ECOG-PS scores of 2 (5.4 vs. 2.4 months; P=0.006). In addition, a PFS benefit was observed in patients with EGFR T790M-negative compared with EGFR T790M-positive tumors (mPFS 6.2 vs. 4.4 months; P=0.041). Patients treated with immunotherapy-based combinations as a front-line therapy had a longer mPFS than those in which the combinations were used as a late-line therapy (6.2 vs. 2.4 months; P |
doi_str_mv | 10.3892/ol.2024.14637 |
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The development of effective immunotherapy for this disease has been challenging. In the present study, 37 patients with EGFR-mutant advanced NSCLC who were treated with programmed cell death-1 (PD-1) inhibitor-based combinations after TKI failure were reviewed. The total cohort had a median progression-free survival (mPFS) of 5.2 months (95% CI, 4.077-6.323 months) and a median overall survival (mOS) of 18.3 months (95% CI, 12.932-23.668 months). Patients with Eastern Cooperative Oncology Group performance-status (ECOG-PS) scores of 0 or 1 had longer mPFS than those with ECOG-PS scores of 2 (5.4 vs. 2.4 months; P=0.006). In addition, a PFS benefit was observed in patients with EGFR T790M-negative compared with EGFR T790M-positive tumors (mPFS 6.2 vs. 4.4 months; P=0.041). Patients treated with immunotherapy-based combinations as a front-line therapy had a longer mPFS than those in which the combinations were used as a late-line therapy (6.2 vs. 2.4 months; P<0.001). PD-1 inhibitor combined with chemotherapy and bevacizumab did not show a clear advantage over PD-1 inhibitor combined with chemotherapy alone (mPFS, 6.2 vs. 4.4 months; P=0.681), although it resulted in an improved overall response rate (ORR) and disease control rate. Notably, the 7 patients with a programmed cell death ligand-1 (PD-L1) tumor proportion score of [greater than or equal to]50% had an ORR of 100% and an mPFS of 8.3 months. Therefore, it is suggested that PD-1 inhibitor-based combinations should be a priority treatment option in selective populations, such as those with low ECOG-PS scores, T790M-negative status or high PD-L1 expression in EGFR-mutant NSCLC after TKI failure. The use of immunotherapy and chemotherapy in combination with antiangiogenic agents appears to be a promising combination therapy for such patients. Key words: non-small cell lung cancer, EGFR mutation, immunotherapy, efficacy</description><identifier>ISSN: 1792-1074</identifier><identifier>EISSN: 1792-1082</identifier><identifier>DOI: 10.3892/ol.2024.14637</identifier><language>eng</language><publisher>Athens: Spandidos Publications</publisher><subject>Analysis ; Apoptosis ; Biopsy ; Cancer ; Cancer therapies ; Care and treatment ; Cell death ; Chemotherapy ; Development and progression ; Epidermal growth factor ; Immunohistochemistry ; Immunotherapy ; Kinases ; Lung cancer ; Lung cancer, Non-small cell ; Lung cancer, Small cell ; Medical research ; Medicine, Experimental ; Methods ; Mutation ; Patient outcomes ; Patients</subject><ispartof>Oncology letters, 2024-11, Vol.28 (5), p.1, Article 504</ispartof><rights>COPYRIGHT 2024 Spandidos Publications</rights><rights>Copyright Spandidos Publications UK Ltd. 2024</rights><rights>Copyright: © 2024 Li et al. 2024</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c400t-3e146bafa038474471cd964ddb77957521becd53b2c8e1d5148e1926f8122f1f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369851/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11369851/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids></links><search><creatorcontrib>Li, Meifang</creatorcontrib><creatorcontrib>Lin, Cheng</creatorcontrib><creatorcontrib>Lin, Jinghui</creatorcontrib><creatorcontrib>Chen, Shijie</creatorcontrib><creatorcontrib>Weng, Lihong</creatorcontrib><creatorcontrib>He, Zhiyong</creatorcontrib><title>Efficacy analysis of immunotherapy‑based combinations for patients with EGFR‑mutant advanced non‑small cell lung cancer after TKI failure</title><title>Oncology letters</title><description>Treatment options for epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) following tyrosine kinase inhibitor (TKI) failure are limited, and platinum-based chemotherapy remains the main treatment. The development of effective immunotherapy for this disease has been challenging. In the present study, 37 patients with EGFR-mutant advanced NSCLC who were treated with programmed cell death-1 (PD-1) inhibitor-based combinations after TKI failure were reviewed. The total cohort had a median progression-free survival (mPFS) of 5.2 months (95% CI, 4.077-6.323 months) and a median overall survival (mOS) of 18.3 months (95% CI, 12.932-23.668 months). Patients with Eastern Cooperative Oncology Group performance-status (ECOG-PS) scores of 0 or 1 had longer mPFS than those with ECOG-PS scores of 2 (5.4 vs. 2.4 months; P=0.006). In addition, a PFS benefit was observed in patients with EGFR T790M-negative compared with EGFR T790M-positive tumors (mPFS 6.2 vs. 4.4 months; P=0.041). Patients treated with immunotherapy-based combinations as a front-line therapy had a longer mPFS than those in which the combinations were used as a late-line therapy (6.2 vs. 2.4 months; P<0.001). PD-1 inhibitor combined with chemotherapy and bevacizumab did not show a clear advantage over PD-1 inhibitor combined with chemotherapy alone (mPFS, 6.2 vs. 4.4 months; P=0.681), although it resulted in an improved overall response rate (ORR) and disease control rate. Notably, the 7 patients with a programmed cell death ligand-1 (PD-L1) tumor proportion score of [greater than or equal to]50% had an ORR of 100% and an mPFS of 8.3 months. Therefore, it is suggested that PD-1 inhibitor-based combinations should be a priority treatment option in selective populations, such as those with low ECOG-PS scores, T790M-negative status or high PD-L1 expression in EGFR-mutant NSCLC after TKI failure. The use of immunotherapy and chemotherapy in combination with antiangiogenic agents appears to be a promising combination therapy for such patients. Key words: non-small cell lung cancer, EGFR mutation, immunotherapy, efficacy</description><subject>Analysis</subject><subject>Apoptosis</subject><subject>Biopsy</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Care and treatment</subject><subject>Cell death</subject><subject>Chemotherapy</subject><subject>Development and progression</subject><subject>Epidermal growth factor</subject><subject>Immunohistochemistry</subject><subject>Immunotherapy</subject><subject>Kinases</subject><subject>Lung cancer</subject><subject>Lung cancer, Non-small cell</subject><subject>Lung cancer, Small cell</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Methods</subject><subject>Mutation</subject><subject>Patient outcomes</subject><subject>Patients</subject><issn>1792-1074</issn><issn>1792-1082</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNptUstqHDEQHEICMY6PuQsCuc1Gr3noFIxZOyYGQ3DOokcj7chopI2kcdib_yDkF_Ml0drG8UIk6G66qwtKqqp6T_CK9YJ-Cm5FMeUrwlvWvaqOSCdoTXBPXz_XHX9bnaR0i8tpWtL37VH1a22MVaB2CDy4XbIJBYPsPC8-5ElH2O7-3P8eIOkRqTAP1kO2wSdkQkTbUmufE_pp84TWF-ffCnZeMviMYLwDr8qWD7500wzOIaVLcIvfILUfRgQml3jz9RIZsG6J-l31xoBL-uQpH1ffz9c3Z1_qq-uLy7PTq1pxjHPNdNE5gAHMet5x3hE1ipaP49B1oukaSgatxoYNVPWajA3hJQnamp5Qaohhx9XnR97tMsx6VEVGBCe30c4QdzKAlYcTbye5CXeSENaKviGF4cMTQww_Fp2yvA1LLI-YJCOEMtYI3vxDbcBpab0JhU3NNil52pNWUMGxKKjVf1Dljnq2KnhtbOkfLHx8sTBpcHlKwS0Pf3MIrB-BKoaUojbPEgmWe-PI4OTeOPLBOOwvXTq5rA</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Li, Meifang</creator><creator>Lin, Cheng</creator><creator>Lin, Jinghui</creator><creator>Chen, Shijie</creator><creator>Weng, Lihong</creator><creator>He, Zhiyong</creator><general>Spandidos Publications</general><general>Spandidos Publications UK Ltd</general><general>D.A. Spandidos</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20241101</creationdate><title>Efficacy analysis of immunotherapy‑based combinations for patients with EGFR‑mutant advanced non‑small cell lung cancer after TKI failure</title><author>Li, Meifang ; Lin, Cheng ; Lin, Jinghui ; Chen, Shijie ; Weng, Lihong ; He, Zhiyong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-3e146bafa038474471cd964ddb77957521becd53b2c8e1d5148e1926f8122f1f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Analysis</topic><topic>Apoptosis</topic><topic>Biopsy</topic><topic>Cancer</topic><topic>Cancer therapies</topic><topic>Care and treatment</topic><topic>Cell death</topic><topic>Chemotherapy</topic><topic>Development and progression</topic><topic>Epidermal growth factor</topic><topic>Immunohistochemistry</topic><topic>Immunotherapy</topic><topic>Kinases</topic><topic>Lung cancer</topic><topic>Lung cancer, Non-small cell</topic><topic>Lung cancer, Small cell</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Methods</topic><topic>Mutation</topic><topic>Patient outcomes</topic><topic>Patients</topic><toplevel>online_resources</toplevel><creatorcontrib>Li, Meifang</creatorcontrib><creatorcontrib>Lin, Cheng</creatorcontrib><creatorcontrib>Lin, Jinghui</creatorcontrib><creatorcontrib>Chen, Shijie</creatorcontrib><creatorcontrib>Weng, Lihong</creatorcontrib><creatorcontrib>He, Zhiyong</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Oncology letters</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Meifang</au><au>Lin, Cheng</au><au>Lin, Jinghui</au><au>Chen, Shijie</au><au>Weng, Lihong</au><au>He, Zhiyong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy analysis of immunotherapy‑based combinations for patients with EGFR‑mutant advanced non‑small cell lung cancer after TKI failure</atitle><jtitle>Oncology letters</jtitle><date>2024-11-01</date><risdate>2024</risdate><volume>28</volume><issue>5</issue><spage>1</spage><pages>1-</pages><artnum>504</artnum><issn>1792-1074</issn><eissn>1792-1082</eissn><abstract>Treatment options for epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) following tyrosine kinase inhibitor (TKI) failure are limited, and platinum-based chemotherapy remains the main treatment. The development of effective immunotherapy for this disease has been challenging. In the present study, 37 patients with EGFR-mutant advanced NSCLC who were treated with programmed cell death-1 (PD-1) inhibitor-based combinations after TKI failure were reviewed. The total cohort had a median progression-free survival (mPFS) of 5.2 months (95% CI, 4.077-6.323 months) and a median overall survival (mOS) of 18.3 months (95% CI, 12.932-23.668 months). Patients with Eastern Cooperative Oncology Group performance-status (ECOG-PS) scores of 0 or 1 had longer mPFS than those with ECOG-PS scores of 2 (5.4 vs. 2.4 months; P=0.006). In addition, a PFS benefit was observed in patients with EGFR T790M-negative compared with EGFR T790M-positive tumors (mPFS 6.2 vs. 4.4 months; P=0.041). Patients treated with immunotherapy-based combinations as a front-line therapy had a longer mPFS than those in which the combinations were used as a late-line therapy (6.2 vs. 2.4 months; P<0.001). PD-1 inhibitor combined with chemotherapy and bevacizumab did not show a clear advantage over PD-1 inhibitor combined with chemotherapy alone (mPFS, 6.2 vs. 4.4 months; P=0.681), although it resulted in an improved overall response rate (ORR) and disease control rate. Notably, the 7 patients with a programmed cell death ligand-1 (PD-L1) tumor proportion score of [greater than or equal to]50% had an ORR of 100% and an mPFS of 8.3 months. Therefore, it is suggested that PD-1 inhibitor-based combinations should be a priority treatment option in selective populations, such as those with low ECOG-PS scores, T790M-negative status or high PD-L1 expression in EGFR-mutant NSCLC after TKI failure. The use of immunotherapy and chemotherapy in combination with antiangiogenic agents appears to be a promising combination therapy for such patients. Key words: non-small cell lung cancer, EGFR mutation, immunotherapy, efficacy</abstract><cop>Athens</cop><pub>Spandidos Publications</pub><doi>10.3892/ol.2024.14637</doi><oa>free_for_read</oa></addata></record> |
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subjects | Analysis Apoptosis Biopsy Cancer Cancer therapies Care and treatment Cell death Chemotherapy Development and progression Epidermal growth factor Immunohistochemistry Immunotherapy Kinases Lung cancer Lung cancer, Non-small cell Lung cancer, Small cell Medical research Medicine, Experimental Methods Mutation Patient outcomes Patients |
title | Efficacy analysis of immunotherapy‑based combinations for patients with EGFR‑mutant advanced non‑small cell lung cancer after TKI failure |
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