多西紫杉醇
医学
内科学
催眠药
肺癌
化疗
肿瘤科
危险系数
比例危险模型
癌症
胃肠病学
置信区间
外科
作者
Atsushi Nakamura,Ou Yamaguchi,Keita Mori,Keita Miura,Motohiro Tamiya,Tomohiro Oba,Noriko Yanagitani,Hideaki Mizutani,Takashi Ninomiya,Tomosue Kajiwara,Kentaro Ito,Akihiko Miyanaga,Daisuke Arai,Hiroaki Kodama,Kunihiko Kobayashi,Kyoichi Kaira
标识
DOI:10.1016/j.ejca.2023.01.025
摘要
Ramucirumab plus docetaxel (RD) is a promising treatment for previously treated advanced non-small cell lung cancer (NSCLC). However, its clinical significance after platinum-based chemotherapy plus programmed death-1 (PD-1) blockade remains unclear.What is the clinical significance of RD as a second-line treatment after the failure of chemo-immunotherapy in NSCLC?In this multicentre retrospective study, 288 patients with advanced NSCLC who received RDas second-line therapy after platinum-based chemotherapy plus PD-1 blockade, at 62 Japanese institutions from January 2017 to August 2020, were included. Prognostic analyses were performed using the log-rank test. Prognostic factor analyses were performed using a Cox regression analysis.A total of 288 patients were enrolled: 222 were men (77.1%), 262 were aged <75 years (91.0%), 237 (82.3%) had smoking history and 269 (93.4%) had a performance status (PS) of 0-1. One hundred ninety-nine patients (69.1%) were classified as adenocarcinoma (AC) and 89 (30.9%) as non-AC. The types of PD-1 blockade used in the first-line treatment were anti-PD-1 antibody and anti-programmed death-ligand 1 antibody in 236 (81.9%) and 52 (18.1%) patients, respectively. The objective response rate for RD was 28.8% (95% confidence interval [CI], 23.7-34.4). The disease control rate was 69.8% (95% CI, 64.1-75.0).The median progression free survival and overall survival were 4.1 months (95% CI, 3.5-4.6) and 11.6 months (95% CI, 9.9-13.9), respectively. In a multivariate analysis, non-AC and PS 2-3 were independent prognostic factors for worse progression free survival , while bone metastasis on diagnosis, PS 2-3 and non-AC were identified as independent prognostic factors for poor overall survival.RD is a feasible second-line treatment in patients with advanced NSCLC who had received combined chemo-immunotherapy with PD-1 blockade.UMIN000042333.
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