肺癌靶向治疗进展-2012(周彩存).pdf

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1、肺癌靶向治疗进展－2012同济大学附属上海市肺科医院肿瘤科周彩存TargetingtheEpidermalGrowthFactorReceptorEGFR突变：EGFRTKI一线首选西妥昔单抗在晚期NSCLC治疗中地位？SELECT第二代EGFRTKI有效LUX-Lung3PF-299[TITLE]Supplementaryanalysis:influenceofEGFRTKIandchemotherapyonOSEventsMedian1.0nn(%)(months)95%CIReceivedchemoonly*2117(81)11.707.29–22.870.8R

2、eceivedEGFRTKIonly‡3322(67)20.6716.62–28.32ReceivedEGFRTKIandchemo§9450(53)30.3925.99–NR0.60.4OSprobabilityPatientsreceivingEGFRTKIandchemovspatientsreceivingchemoonlyp=0.00010.2PatientsreceivingEGFRTKIonlyvspatientsreceivingchemoonlyp=0.057Log-rankpvalue<0.000100510152025303540Patientsatr

3、iskTime(months)Patientsreceivingchemoonly*21171286430PatientsreceivingEGFRTKIonly‡33322724171270PatientsreceivingEGFRTKIandchemo§949489806860286*Chemoonly,noEGFRTKI:patientsfromtheGCarmwhohadnofurthertreatment(n=16)orfurtherchemotherapy(n=5)‡EGFRTKIonly,nochemo:patientsfromtheerlotinibarmw

4、hoarestillontreatment(n=7),hadnofurthertreatment(n=25)andwhowerere-challenged(n=1)§EGFRTKIandchemo:patientsfromtheerlotinibarmwhoswitchedtochemo(n=43),patientsfromtheGCarmwhoswitchedtoerlotinibinanyline(n=51)[TITLE]Primaryendpoint:PFSIndependentreview‒allrandomizedpatients1.0AfatinibCis/pe

5、mn=230n=115PFSevent,n(%)152(66)69(60)0.8MedianPFS(months)11.16.9Hazardratio0.58(0.43–0.78)0.6ival(probability)(95%confidenceinterval)P=0.000447%0.40.222%Progression-freesurv0.00369121518212427Progression-freesurvival(months)NumberatriskAfatinib2301801511207750311030Cis/Pem1157241211173200Y

6、angJC,etal.PFS:Commonmutations(Del19/L858R)Independentreview–patientswithDel19/L858R(n=308)1.0AfatinibCis/pemn=204n=1040.8PFSevent,n(%)130(64)61(59)MedianPFS(months)13.66.9Hazardratio0.47(0.34–0.65)0.6(95%confidenceinterval)P<0.00010.40.2Progression-freesurvival(probability)0.0036912151821

7、2427Progression-freesurvival(months)NumberatriskAfatinib2041691431157549301030Cis/Pem104623517962200YangJC,etal.[TITLE][TITLE]First-linedacomitinib(PF-00299804),anirreversiblepan-HERtyrosinekinaseinhibitorforpatientswithEGFR-mutantlungcancerMGKris,Mok,SHIOu,et