Abstract：
Treatment options for advanced non-small-cell lung cancer (NSCLC) after osimertinib failure are limited, and osimertinib continuation is recommended for selected patients. Metronomic oral vinorelbine is an effective treatment with less toxicity for advanced NSCLC.
The objective of the study was to investigate the effects of osimertinib plus metronomic oral vinorelbine on epidermal growth factor receptor (EGFR)-mutant advanced NSCLC beyond limited progression on osimertinib.
We have reviewed the medical records of 28 patients with EGFR-mutant advanced NSCLC who had received osimertinib continuation plus metronomic oral vinorelbine beyond limited progression on osimertinib. We also evaluated the clinicopathological characteristics of enrolled patients, as well as the efficacy and toxicity of the treatment.
After a median follow-up period of 14.1 months, 57.1% (16/28) of cases showed NSCLC progression. The median progression-free survival (PFS) period under osimertinib plus metronomic oral vinorelbine was 9.4 months (95% confidence interval, 1.562-17.238 months), with a disease control rate of 89.3% and objective response rate of 17.9%. PFS did not differ between patients who had previously received osimertinib as first- (n = 16) and second-line (n = 12) therapy (median, 11.4 and 4.7 months, P = 0.391). In addition, the median PFS duration did not differ according to the efficacy (PFS2 ≥ 6 months vs. <6 months) of previous osimertinib monotherapy (median, 5.8 and 9.4 months, P = 0.677).
Osimertinib continuation in conjunction with metronomic oral vinorelbine may enable overcoming TKI resistance and prolong the survival of patients with EGFR-mutant advanced NSCLC beyond limited progression on osimertinib treatment.
The objective of the study was to investigate the effects of osimertinib plus metronomic oral vinorelbine on epidermal growth factor receptor (EGFR)-mutant advanced NSCLC beyond limited progression on osimertinib.
We have reviewed the medical records of 28 patients with EGFR-mutant advanced NSCLC who had received osimertinib continuation plus metronomic oral vinorelbine beyond limited progression on osimertinib. We also evaluated the clinicopathological characteristics of enrolled patients, as well as the efficacy and toxicity of the treatment.
After a median follow-up period of 14.1 months, 57.1% (16/28) of cases showed NSCLC progression. The median progression-free survival (PFS) period under osimertinib plus metronomic oral vinorelbine was 9.4 months (95% confidence interval, 1.562-17.238 months), with a disease control rate of 89.3% and objective response rate of 17.9%. PFS did not differ between patients who had previously received osimertinib as first- (n = 16) and second-line (n = 12) therapy (median, 11.4 and 4.7 months, P = 0.391). In addition, the median PFS duration did not differ according to the efficacy (PFS2 ≥ 6 months vs. <6 months) of previous osimertinib monotherapy (median, 5.8 and 9.4 months, P = 0.677).
Osimertinib continuation in conjunction with metronomic oral vinorelbine may enable overcoming TKI resistance and prolong the survival of patients with EGFR-mutant advanced NSCLC beyond limited progression on osimertinib treatment.
摘要：
背景：奥希替尼失败后晚期非小细胞肺癌（NSCLC）的治疗选择有限，对于选定的患者,建议继续使用奥希替尼.口服长春瑞滨是治疗晚期NSCLC的有效方法，毒性较小。
目的：本研究的目的是研究奥希替尼联合口服长春瑞滨对表皮生长因子受体（EGFR）突变型晚期NSCLC的疗效，而不是奥希替尼的有限进展。
方法：我们回顾了28例EGFR突变型晚期非小细胞肺癌患者的医疗记录，这些患者接受了奥希替尼的持续治疗加口服长春瑞滨，但进展有限。我们还评估了入选患者的临床病理特征，以及治疗的疗效和毒性。
结果：中位随访时间为14.1个月后，57.1％（16/28）的病例显示NSCLC进展。奥希替尼联合口服长春瑞滨的中位无进展生存期(PFS)为9.4个月(95%置信区间,1.562-17.238个月），疾病控制率为89.3%，客观缓解率为17.9%。先前接受奥希替尼作为一线（n=16）和二线（n=12）治疗的患者的PFS没有差异（中位数，11.4和4.7个月，P=0.391)。此外,根据疗效，中位PFS持续时间没有差异(PFS2≥6个月与<6个月)以前的奥希替尼单一疗法(中位数，5.8和9.4个月，P=0.677)。
结论：奥希替尼继续与口服长春瑞滨联合使用可能能够克服TKI耐药，并延长EGFR突变型晚期NSCLC患者的生存期，超过奥希替尼治疗的有限进展。
目的：本研究的目的是研究奥希替尼联合口服长春瑞滨对表皮生长因子受体（EGFR）突变型晚期NSCLC的疗效，而不是奥希替尼的有限进展。
方法：我们回顾了28例EGFR突变型晚期非小细胞肺癌患者的医疗记录，这些患者接受了奥希替尼的持续治疗加口服长春瑞滨，但进展有限。我们还评估了入选患者的临床病理特征，以及治疗的疗效和毒性。
结果：中位随访时间为14.1个月后，57.1％（16/28）的病例显示NSCLC进展。奥希替尼联合口服长春瑞滨的中位无进展生存期(PFS)为9.4个月(95%置信区间,1.562-17.238个月），疾病控制率为89.3%，客观缓解率为17.9%。先前接受奥希替尼作为一线（n=16）和二线（n=12）治疗的患者的PFS没有差异（中位数，11.4和4.7个月，P=0.391)。此外,根据疗效，中位PFS持续时间没有差异(PFS2≥6个月与<6个月)以前的奥希替尼单一疗法(中位数，5.8和9.4个月，P=0.677)。
结论：奥希替尼继续与口服长春瑞滨联合使用可能能够克服TKI耐药，并延长EGFR突变型晚期NSCLC患者的生存期，超过奥希替尼治疗的有限进展。
