We retrospectively analysed patients with stage IIIA-IV NSCLC and driver gene mutations, whose baseline tumour marker levels exceeded the pre-treatment cut-off value three-fold and who received TKI-targeted therapy as a first-line treatment. We compared efficacy, progression-free survival (PFS), and overall survival (OS) between RecistTM and RECIST.
The median PFS and OS differed significantly among treatment-response subgroups based on RecistTM but not RECIST. The predicted 1-, 2-, and 3-year disease-progression risk, according to area under the receiver operating characteristic curve, as well as the 1-, 3-, and 5-year mortality risk, differed significantly between RecistTM and RECIST. The median PFS and OS of tmCR according to RecistTM, was significantly longer than (CR+PR) according to RECIST. Imaging analysis revealed that the ΔPFS was 11.27 and 6.17 months in the intervention and non-intervention groups, respectively, suggesting that earlier intervention could extend patients\' PFS.
RecistTM can assess targeted-therapy efficacy in patients with advanced NSCLC and driver gene mutations, along with tumour marker abnormalities. RecistTM surpasses RECIST in predicting short- and long-term patient benefits, and allows the early identification of patients resistant to targeted drugs, enabling prompt intervention and extending the imaging-demonstrated time to progression.
方法:我们回顾性分析了IIIA-IV期非小细胞肺癌和驱动基因突变的患者,其基线肿瘤标志物水平超过治疗前临界值3倍,并接受TKI靶向治疗作为一线治疗。我们比较了疗效,无进展生存期(PFS),RecistTM和RECIST之间的总生存期(OS)。
结果:基于RecristTM而非RECIST的治疗反应亚组的中位PFS和OS差异显著。预测的1-,2-,和3年的疾病进展风险,根据接收器工作特性曲线下的面积,以及1-,3-,和5年死亡风险,RecystTM和RECIST之间存在显着差异。根据RecistTM,tmCR的PFS和OS中位数,根据RECIST,显著长于(CR+PR)。影像学分析显示,干预组和非干预组的ΔPFS分别为11.27和6.17个月,分别,这表明早期干预可以延长患者的PFS。
结论:RecristTM可以评估晚期NSCLC和驱动基因突变患者的靶向治疗疗效,以及肿瘤标志物异常。RecystTM在预测短期和长期患者获益方面超过RECIST,并允许早期识别对靶向药物耐药的患者,能够及时干预并延长影像学显示的进展时间。