A retrospective study of the efficacy of combined EGFR‑TKI plus VEGF inhibitor/cytotoxic therapy vs. EGFR‑TKI monotherapy for PD‑L1‑positive EGFR‑mutant non‑small cell lung cancer: North Japan Lung Cancer Study Group 2202

Inomata,Minehiko; Kawashima,Yosuke; Saito,Ryota; Morinaga,Daisuke; Nogawa,Hitomi; Sato,Masamichi; Suzuki,Yohei; Yanagisawa,Satoru; Kikuchi,Takashi; Jingu,Daisuke; Yoshimura,Naruo; Harada,Toshiyuki; Miyauchi,Eisaku

doi:10.3892/ol.2023.13920

A retrospective study of the efficacy of combined EGFR‑TKI plus VEGF inhibitor/cytotoxic therapy vs. EGFR‑TKI monotherapy for PD‑L1‑positive EGFR‑mutant non‑small cell lung cancer: North Japan Lung Cancer Study Group 2202

Authors:
- Minehiko Inomata
- Yosuke Kawashima
- Ryota Saito
- Daisuke Morinaga
- Hitomi Nogawa
- Masamichi Sato
- Yohei Suzuki
- Satoru Yanagisawa
- Takashi Kikuchi
- Daisuke Jingu
- Naruo Yoshimura
- Toshiyuki Harada
- Eisaku Miyauchi
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Affiliations: First Department of Internal Medicine, Toyama University Hospital, Toyama 930‑0194, Japan, Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Miyagi 980‑0873, Japan, Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Miyagi 980‑8574, Japan, Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido 060‑8648, Japan, Department of Respiratory Medicine, Yamagata Prefectural Central Hospital, Yamagata 990‑2292, Japan, Department of Cardiology, Pulmonology, and Nephrology, Yamagata University Faculty of Medicine, Yamagata 990‑9585, Japan, Department of Thoracic Surgery, Omagari Kosei Medical Center, Daisen, Akita 014‑0027, Japan, Department of Respiratory Medicine, Saku Central Hospital Advanced Care Center, Saku, Nagano 385‑0051, Japan, Department of Respiratory Medicine, Iwate Prefectural Isawa Hospital, Ohshu, Iwate 023‑0864, Japan, Department of Respiratory Medicine, Saka General Hospital, Shiogama, Miyagi 985‑8506, Japan, Department of Respiratory Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Miyagi 983‑8512, Japan, Department of Respiratory Medicine, Japan Community Health Care Organization Hokkaido Hospital, Sapporo, Hokkaido 062‑0921, Japan, Department of Respiratory Medicine, Tohoku University Hospital, Sendai, Miyagi 980‑8574, Japan
Published online on: June 20, 2023 https://doi.org/10.3892/ol.2023.13920
Article Number: 334
Copyright: © Inomata et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present multicenter study was performed to compare the efficacy of epidermal growth factor receptor‑tyrosine kinase inhibitor (EGFR‑TKI) monotherapy with that of combined EGFR‑TKI plus vascular endothelial growth factor receptor (VEGF) inhibitor/cytotoxic therapy in patients with programmed death‑ligand 1 (PD‑L1)‑positive EGFR‑mutant non‑small cell lung cancer (NSCLC). Data from patients with PD‑L1‑positive EGFR‑mutant NSCLC were collected from 12 institutes. Survival in patients treated with first‑ and second‑generation EGFR‑TKIs, osimertinib (third‑generation EGFR‑TKI), and combined EGFR‑TKI plus VEGF inhibitor/cytotoxic therapy was analyzed by multiple regression analysis with adjustments for sex, performance status, EGFR mutation status, PD‑L1 expression level, and the presence or absence of brain metastasis using a Cox proportional hazards model. Data from a total of 263 patients were analyzed, including 111 (42.2%) patients who had received monotherapy with a first‑ or second‑generation EGFR‑TKI, 132 (50.2%) patients who had received osimertinib monotherapy, and 20 (7.6%) patients who had received combined EGFR‑TKI plus VEGF inhibitor/cytotoxic therapy (hereafter referred to as combined therapy). Multiple regression analysis using the Cox proportional hazards model showed that the hazard ratio (95% confidence interval) for progression‑free survival was 0.73 (0.54‑1.00) in the patients who had received osimertinib monotherapy and 0.47 (0.25‑0.90) in patients who had received combined therapy. The hazard ratio for overall survival was 0.98 (0.65‑1.48) in the patients who had received osimertinib monotherapy and 0.52 (0.21‑1.31) in patients who had received combined therapy. In conclusion, combined therapy was associated with a significant reduction in the risk of progression compared with first‑ and second‑generation EGFR‑TKI monotherapy, and therefore, may be promising for the treatment of patients of NSCLC.

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