A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice
Abstract Purpose For the first-line treatment of KRAS mutant non-small cell lung cancer (NSCLC) patients, immunotherapy or platinum-based chemotherapy are the main treatment method. Here, we investigated the clinical efficacy and prognosis those two regimens as first-line treatment in real-world pra...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-11-01
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| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-022-10236-9 |
| _version_ | 1811319280358129664 |
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| author | Yanxia Liu Yuan Gao Ying Wang Cong Zhao Zhiyun Zhang Baolan Li Tongmei Zhang |
| author_facet | Yanxia Liu Yuan Gao Ying Wang Cong Zhao Zhiyun Zhang Baolan Li Tongmei Zhang |
| author_sort | Yanxia Liu |
| collection | DOAJ |
| description | Abstract Purpose For the first-line treatment of KRAS mutant non-small cell lung cancer (NSCLC) patients, immunotherapy or platinum-based chemotherapy are the main treatment method. Here, we investigated the clinical efficacy and prognosis those two regimens as first-line treatment in real-world practice. Methods KRAS mutant NSCLC patients received chemotherapy or immunotherapy as first-line treatment from September 2014 to March 2022 were enrolled. Clinical characteristics, treatment scheme, clinical curative effect and follow-up data of enrolled patients were collected for analysis. Results Fifty patients received immunotherapy and 115 patients received chemotherapy were enrolled. Patients who received immunotherapy (HR = 0.350, 95%CI 0.156–0.781, P = 0.010), or pemetrexed-based regimen (HR = 0.486, 95%CI 0.255–0.928, P = 0.029), or antiangiogenic therapy (HR = 0.355, 95%CI 0.159–0.790, P = 0.011) were at a low risk of disease progression. And patients received antiangiogenic therapy had lower risk of death than those not (HR = 0.333, 95%CI 0.120–0.926, P = 0.035). Subgroup analysis revealed the immunotherapy compared to chemotherapy alone had lower risk of disease progression (HR = 0.377, 95%CI 0.166–0.856, P = 0.020) in PD-L1 expression ≥1% subgroup. And in non-G12C KRAS subgroup, but not in G12C KRAS subgroup, patients who received antiangiogenic therapy had lower risk of disease progression (HR = 0.254, 95%CI 0.098–0.656, P = 0.005) and death than those not (HR = 0.197, 95%CI 0.056–0.692, P = 0.011). In terms of different chemotherapy regimen, platinum-paclitaxel combined with antiangiogenic therapy achieved the highest ORR and DCR (P < 0.05), while the platinum-pemetrexed combined with antiangiogenic therapy had the longest PFS and OS (P < 0.001). Conclusion For the first-line treatment of KRAS mutant NSCLC patients, immunotherapy, antiangiogenic therapy, and pemetrexed-based regimen could obtain more benefits. Subgroup analysis revealed the benefits of immunotherapy compared to chemotherapy were applicable in PD-L1 expression≥1% subgroup, and antiangiogenic therapy could benefit non-G12C KRAS subgroup, but not G12C KRAS subgroup. In terms of different chemotherapy regimen, platinum-pemetrexed combined with antiangiogenic therapy may be the preferred chemotherapy regimen. |
| first_indexed | 2024-04-13T12:40:01Z |
| format | Article |
| id | doaj.art-578ef8698f604edca4da4c0990140976 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T12:40:01Z |
| publishDate | 2022-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-578ef8698f604edca4da4c09901409762022-12-22T02:46:32ZengBMCBMC Cancer1471-24072022-11-0122111410.1186/s12885-022-10236-9A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practiceYanxia Liu0Yuan Gao1Ying Wang2Cong Zhao3Zhiyun Zhang4Baolan Li5Tongmei Zhang6Medical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityMedical Oncology, Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical UniversityAbstract Purpose For the first-line treatment of KRAS mutant non-small cell lung cancer (NSCLC) patients, immunotherapy or platinum-based chemotherapy are the main treatment method. Here, we investigated the clinical efficacy and prognosis those two regimens as first-line treatment in real-world practice. Methods KRAS mutant NSCLC patients received chemotherapy or immunotherapy as first-line treatment from September 2014 to March 2022 were enrolled. Clinical characteristics, treatment scheme, clinical curative effect and follow-up data of enrolled patients were collected for analysis. Results Fifty patients received immunotherapy and 115 patients received chemotherapy were enrolled. Patients who received immunotherapy (HR = 0.350, 95%CI 0.156–0.781, P = 0.010), or pemetrexed-based regimen (HR = 0.486, 95%CI 0.255–0.928, P = 0.029), or antiangiogenic therapy (HR = 0.355, 95%CI 0.159–0.790, P = 0.011) were at a low risk of disease progression. And patients received antiangiogenic therapy had lower risk of death than those not (HR = 0.333, 95%CI 0.120–0.926, P = 0.035). Subgroup analysis revealed the immunotherapy compared to chemotherapy alone had lower risk of disease progression (HR = 0.377, 95%CI 0.166–0.856, P = 0.020) in PD-L1 expression ≥1% subgroup. And in non-G12C KRAS subgroup, but not in G12C KRAS subgroup, patients who received antiangiogenic therapy had lower risk of disease progression (HR = 0.254, 95%CI 0.098–0.656, P = 0.005) and death than those not (HR = 0.197, 95%CI 0.056–0.692, P = 0.011). In terms of different chemotherapy regimen, platinum-paclitaxel combined with antiangiogenic therapy achieved the highest ORR and DCR (P < 0.05), while the platinum-pemetrexed combined with antiangiogenic therapy had the longest PFS and OS (P < 0.001). Conclusion For the first-line treatment of KRAS mutant NSCLC patients, immunotherapy, antiangiogenic therapy, and pemetrexed-based regimen could obtain more benefits. Subgroup analysis revealed the benefits of immunotherapy compared to chemotherapy were applicable in PD-L1 expression≥1% subgroup, and antiangiogenic therapy could benefit non-G12C KRAS subgroup, but not G12C KRAS subgroup. In terms of different chemotherapy regimen, platinum-pemetrexed combined with antiangiogenic therapy may be the preferred chemotherapy regimen.https://doi.org/10.1186/s12885-022-10236-9KRAS mutationNSCLCFirst-line treatmentImmunotherapyAntiangiogenic therapy |
| spellingShingle | Yanxia Liu Yuan Gao Ying Wang Cong Zhao Zhiyun Zhang Baolan Li Tongmei Zhang A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice BMC Cancer KRAS mutation NSCLC First-line treatment Immunotherapy Antiangiogenic therapy |
| title | A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice |
| title_full | A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice |
| title_fullStr | A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice |
| title_full_unstemmed | A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice |
| title_short | A single center analysis of first-line treatment in advanced KRAS mutant non-small cell lung cancer: real-world practice |
| title_sort | single center analysis of first line treatment in advanced kras mutant non small cell lung cancer real world practice |
| topic | KRAS mutation NSCLC First-line treatment Immunotherapy Antiangiogenic therapy |
| url | https://doi.org/10.1186/s12885-022-10236-9 |
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