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Lung cancer is the malignant tumor with the highest morbidity and mortality in China.
Most patients have advanced disease at the time of diagnosis , which is a serious threat to life and health
.
On August 12, led by Professor Wu Yilong , the life director of Guangdong Provincial People’s Hospital and the honorary director of Guangdong Lung Cancer Research Institute, Professor Zhou Qing, as the main undertaker of the study, conducted a stage III phase of non-small cell lung cancer patients with EGFR mutations.
Lung cancer is the malignant tumor with the highest morbidity and mortality in China.
Combination therapy extended the median progression-free survival of such patients from 11.
2 months to 17.
9 months, and reduced the risk of disease progression by 45%.
The toxicity of the therapy is manageable and tolerable, and can be regarded as advanced, metastatic or The first-line treatment option for patients with relapsed EGFR mutation-positive non-small cell lung cancer
.
Explore the combined treatment strategy of erlotinib and other drugs
Explore the combined treatment strategy of erlotinib and other drugsLung cancer is divided into non-small cell lung cancer and small cell lung cancer.
Among them, non-small cell lung cancer accounts for about 80% of all lung cancers
.
In non-small cell lung cancer, 30%-40% of patients will carry epidermal growth factor receptor (EGFR) gene mutations
Although targeted therapies, such as erlotinib, can benefit such patients, most patients receiving erlotinib monotherapy will develop resistance, leading to treatment failure
.
At the same time, patients with different clinical characteristics and different mutation subtypes have different benefits in monotherapy
How to improve the efficacy, especially for special populations who have relatively little benefit from erlotinib alone? Wu Yilong's team began to explore the combined treatment strategy of erlotinib and other drugs
.
ARTEMIS-CTONG1509 came into being
In 2015, the ARTEMIS-CTONG1509 study was launched.
In 14 centers across the country, 311 patients with EGFR mutations and untreated advanced non-small cell lung cancer were selected for bevacizumab combined with erlotinib and erlotinib.
Drug treatment, research and comparison of the efficacy and safety of the two therapies
.
At the 2019 European Society of Medical Oncology (ESMO) annual meeting, Professor Zhou Qing, deputy director of the Guangdong Lung Cancer Institute, released the clinical data characteristics and translational research results of the ARTEMIS-CTONG1509 study on behalf of the research team
.
The results of the study showed that bevacizumab combined with erlotinib treatment can significantly prolong the progression-free survival of patients, with a median progression-free survival of 17.
9 months, which is longer than that of erlotinib monotherapy (11.
2 months).
In half a year, the patient's risk of disease progression was reduced by 45%
.
At the same time, the study found that patients with exon 21 L858R point mutations not only benefit from combination therapy than erlotinib single-agent therapy, but the benefits also exceed those of patients with exon 19 deletion mutations from combination therapy.
In the benefits
.
In patients with brain metastases, the combination therapy not only significantly prolonged the progression-free survival, but even has a trend of prolonging the overall survival.
It can be seen that the combination therapy has a better effect on patients with L858R point mutations in exon 21 and patients with brain metastases
.
In the observation of adverse reactions, the research team found that the adverse reactions of the two drugs in the combined treatment group were superimposed
.
Zhou Qing said that the common adverse reactions of bevacizumab are hypertension and proteinuria.
A study of almost the same content conducted in Japan during the same period also confirmed the effectiveness of the combination therapy
.
Compared with the Japanese study, the ARTEMIS-CTONG1509 study adds an analysis of the efficacy and safety of combination therapy on patients with exon 21 L858R point mutations and brain metastases, which is unique in the study of special populations
Last year, the treatment of bevacizumab combined with erlotinib was written into the Chinese Society of Clinical Oncology " Guidelines for the Diagnosis and Treatment of Primary Lung Cancer " (2020 edition), becoming one of the first-line treatment options for patients with EGFR gene mutations
.
Wu Yilong said that at present, the two targeted therapies of bevacizumab and erlotinib have been included in the scope of medical insurance in Guangzhou.
After the patient is reimbursed, the monthly treatment cost is about 2,000 yuan
.
This treatment plan will benefit more patients after being widely used
.
For the treatment of lung cancer, Wu Yilong and his team have many new ideas waiting to be verified, including exploring various combined treatment methods, starting with drug resistance mechanisms to prevent the emergence of drug resistance, exploring the possibility of intermittent treatment, and finding new treatment strategies
.
"Recently, some research is preparing to start
.
If these four aspects can be achieved in the next ten years, it will be a very remarkable achievement
.
" Wu Yilong said
.
Original source:
Original source:Qing Zhou, Chong-Rui Xu, Ying Cheng, Yun-Peng Liu, Gong-Yan Chen, Jiu-Wei Cui, Nong Yang, Yong Song, Xiao-Ling Li, Shun Lu, Jian-Ying Zhou, Zhi-Yong Ma, Shi-Ying Yu, Cheng Huang, Yong-Qian Shu, Zhen Wang, Jin-Ji Yang, Hai-Yan Tu, Wen-Zhao Zhong, Yi-Long Wu.
Bevacizumab plus erlotinib in Chinese patients with untreated, EGFR -mutated, advanced NSCLC (ARTEMIS-CTONG1509): A multicenter phase 3 study.
Cancer Cell, 2021,https://doi.
org/10.
1016/j.
ccell.
2021.
07.
005.
Bevacizumab plus erlotinib in Chinese patients with untreated, EGFR -mutated, advanced NSCLC (ARTEMIS-CTONG1509): A multicenter phase 3 study.
Cancer Cell, 2021,https://doi.
org/10.
1016/j.
ccell.
2021.
07.
005.
Bevacizumab plus erlotinib in Chinese patients with untreated, EGFR -mutated, advanced EGFR NSCLC (ARTEMIS-CTONG1509): A multicenter phase 3 study.
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