A total of 31 c-SCLC patients with gene mutations were retrospectively included and grouped according to their treatment regimens. Treatment outcomes were evaluated. Kaplan-Meier method was used for survival analysis, with Log Rank test applied for comparison between groups.
We divided the 31 patients into 3 groups according to first-line treatment: group A (chemotherapy, n = 16), group B (targeted monotherapy, n = 7), and group C (targeted combination therapy, n = 8). The overall response rates (ORR) were 43.8%, 42.9%, and 62.5%. The disease control rates (DCR) were 87.5%, 85.7%, and 100%. The median progression-free survival (PFS) was 4.0, 5.0, and 7.93 months (P = .024), with a significant difference between group A and C (P = .010). The median overall survival (OS) was 14.10, 17.43, and 12.93 months (P = .313). Seven patients in group A received targeted therapy in later-line. Of the total 22 patients received targeted monotherapy or combination therapy, the ORR and DCR were 54.5% and 90.9%. The median PFS and OS were 5.87 and 17.30 months. Additionally, adverse events (AEs) occurred in 53.8% and 88.9% of monotherapy and combination therapy. The most common AEs in monotherapy were elevated transaminases (23.1%) and in combination anemia (66.7%).
TKIs showed encouraging efficacy in driver-gene-positive c-SCLC. While monotherapy may be a supplementary option, combination with chemotherapy appears to be preferable and superior.
方法:回顾性纳入31例有基因突变的c-SCLC患者,并根据治疗方案分组。评估治疗结果。采用Kaplan-Meier法进行生存分析,采用LogRank检验进行组间比较。
结果:我们根据一线治疗将31例患者分为3组:A组(化疗,n=16),B组(靶向单一疗法,n=7),和C组(靶向联合治疗,n=8)。总有效率(ORR)为43.8%,42.9%,62.5%。疾病控制率(DCR)为87.5%,85.7%,和100%。中位无进展生存期(PFS)分别为4.0、5.0和7.93个月(P=0.024),A组和C组之间存在显著差异(P=.010)。中位总生存期(OS)分别为14.10、17.43和12.93个月(P=.313)。A组7例患者在后期行靶向治疗。在总共22例患者中接受靶向单一疗法或联合疗法,ORR和DCR分别为54.5%和90.9%。中位PFS和OS分别为5.87和17.30个月。此外,单药治疗和联合治疗的不良事件(AE)发生率分别为53.8%和88.9%.单药治疗中最常见的不良事件是转氨酶升高(23.1%)和联合贫血(66.7%)。
结论:TKI在驱动基因阳性c-SCLC中显示出令人鼓舞的疗效。虽然单一疗法可能是一种补充选择,联合化疗似乎是更好和更好的。