背景:关于免疫检查点抑制剂(ICI)组合在非小细胞肺癌(NSCLC)中的功效的数据有限,在基因如ERBB2,BRAF,RET,和MET。这项研究回顾性评估了ICI联合治疗在NSCLC分子亚群中的结果。
方法:我们回顾性分析了晚期非小细胞肺癌患者,这些晚期非小细胞肺癌患者的基因包括ERBB2、BRAF、RET或MET,并于2018年1月至2024年5月在湖南省肿瘤医院接受ICI联合化疗(ICI+化疗)和/或靶向治疗(ICI+化疗/TT)作为一线(1L)或二线或三线(≥2L)治疗.
结果:在纳入研究的181名患者中,131例患者接受了1L-ICI+化疗(ERBB2,n=64;BRAF,n=34;RET,n=23;和MET,n=10),50例患者接受≥2L-ICI+化疗/TT(ERBB2,n=16;BRAF,n=7;RET,n=14;MET,n=13)。整个队列的总缓解率(ORR)为45.9%,疾病控制率为84.0%。在接受1L-ICI+化疗的患者中,ORR介于51.6%和60.0%之间,ERBB2改变肿瘤患者的中位无进展生存期(mPFS)和总生存期(mOS)分别为8.2和21.0个月,BRAF改变的肿瘤10.0和15.0个月,12.1个月,RET改变的肿瘤未达到OS,MET改变的肿瘤为6.2个月和28.0个月,分别。此外,≥2L-ICI+chemo/TT的ORR介于14.3%和30.8%之间;ERBB2改变肿瘤患者的mPFS和mOS分别为5.4和16.2个月,2.7和5.0个月的BRAF改变的肿瘤,RET改变的肿瘤为6.2和14.3个月,MET改变的肿瘤为5.7和11.5个月,分别。
结论:基于ICI的联合治疗,不管处理线,在治疗具有ERBB2,BRAF驱动改变的晚期NSCLC患者中有效RET,或MET。这表明它们在该患者人群中作为替代治疗选择的潜力。
BACKGROUND: Limited data exists on the efficacy of immune checkpoint inhibitor (ICI) combinations in non-small-cell lung cancer (NSCLC) with uncommon driver alterations in genes such as
ERBB2, BRAF, RET, and MET. This study retrospectively assessed ICI-combination therapy outcomes in this molecular subset of NSCLC.
METHODS: We retrospectively analyzed patients with advanced NSCLC confirmed with driver alterations in genes including
ERBB2, BRAF, RET or MET, and received ICI combined with chemotherapy (ICI + chemo) and/or targeted therapy (ICI + chemo/TT) as first-line (1L) or second- or third-line (≥ 2L) treatment at Hunan Cancer Hospital between January 2018 and May 2024.
RESULTS: Of the 181 patients included in the study, 131 patients received 1L-ICI + chemo (
ERBB2, n = 64; BRAF, n = 34; RET, n = 23; and MET, n = 10), and 50 patients received ≥ 2L-ICI + chemo/TT (
ERBB2, n = 16; BRAF, n = 7; RET, n = 14; MET, n = 13). The full cohort had an overall response rate (ORR) of 45.9% and disease control rate of 84.0%. Among patients who received 1L-ICI + chemo, ORR ranged between 51.6% and 60.0%, with the median progression-free survival (mPFS) and overall survival (mOS) of 8.2 and 21.0 months for those with
ERBB2-altered tumors, 10.0 and 15.0 months for BRAF-altered tumors, 12.1 months and OS not reached for RET-altered tumors, and 6.2 and 28.0 months for MET-altered tumors, respectively. Additionally, ORR ranged between 14.3% and 30.8% for ≥ 2L-ICI + chemo/TT; mPFS and mOS were 5.4 and 16.2 months for patients with ERBB2-altered tumors, 2.7 and 5.0 months for BRAF-altered tumors, 6.2 and 14.3 months for RET-altered tumors, and 5.7 and 11.5 months for MET-altered tumors, respectively.
CONCLUSIONS: ICI-based combination therapies, regardless of treatment line, were effective in treating patients with advanced NSCLC harboring driver alterations in ERBB2, BRAF, RET, or MET. This suggests their potential as alternative treatment options in this patient population.