Effectiveness of EGFR-TKI rechallenge immediately after PD-1 blockade failure.
Thorac Cancer
; 12(6): 864-873, 2021 03.
Article
em En
| MEDLINE
| ID: mdl-33522139
ABSTRACT
BACKGROUND:
There is currently insufficient information available on effective therapies that can be administered to patients with non-small cell cancer (NSCLC) who develop resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs). However, sequential treatment via programmed death-1 (PD-1) blockade followed by EGFR-TKI rechallenge is suggested to improve the therapeutic efficacy in such patients.METHODS:
A total of 75 patients with advanced NSCLC harboring sensitive EGFR mutations treated with afatinib, erlotinib, or gefitinib after EGFR-TKI treatment failure were retrospectively analyzed. Among them, 13 patients were treated with EGFR-TKI rechallenge immediately after the failure of PD-1 blockade therapy (experimental group) and the remaining 62 patients did not receive PD-1 inhibitor therapy before EGFR-TKI rechallenge (control group). Blood samples were collected at two time points; before the initiation of anti-PD-1 therapy and at EGFR-TKI rechallenge.RESULTS:
The objective response rates of EGFR-TKI rechallenge in the experimental and control groups were 46.1% and 16.1%, respectively, with a significant difference (p = 0.026). In the experimental group, the median progression-free survival (PFS) and overall survival (OS) after EGFR-TKI rechallenge were 5.0 and 25.0 months, respectively, and no statistically significant difference in the percentage of lymphocytes before immune checkpoint inhibitor (ICI) therapy and EGFR-TKIs was observed in patients with partial response (PR) and without PR after EGFR-TKI rechallenge. In particular, the sequential treatment of PD-1 blockade therapy followed by EGFR-TKI rechallenge was consecutively repeated three times in two out of 13 patients in the experimental group, and EGFR-TKI rechallenge consecutively for the third time yielded a PR without increased toxicities.CONCLUSIONS:
EGFR-TKI rechallenge immediately after PD-1 blockade treatment was identified as an effective therapy for NSCLC patients with resistance to EGFR-TKIs.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Inibidores de Proteínas Quinases
/
Inibidores de Checkpoint Imunológico
Tipo de estudo:
Prognostic_studies
Limite:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article