Therapeutic advances in medical oncology · 2026
Atezolizumab and bevacizumab plus chemotherapy versus chemotherapy in non-small cell lung cancer after tyrosine kinase inhibitor failure.
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Hong Moonki, Choi Junho, Lee Seoyoung, Sang Yun Beom, Hong Min Hee, Yeo Ja Hyun, Kim Joo-Hang, Yoon Shinkyo, Kim Chang Gon, Kim Hye Ryun
Аннотация
BACKGROUND: Determining an optimal treatment strategy after tyrosine kinase inhibitor (TKI) failure remains challenging in oncogene-driven non-small cell lung cancer (NSCLC).
OBJECTIVES: We aimed to evaluate and compare the efficacy and safety of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) versus pemetrexed plus carboplatin or cisplatin (PC) in patients with progressive NSCLC harboring EGFR, ALK, or ROS1 alterations after TKI failure.
DESIGN: Multicenter retrospective study.
METHODS: We analyzed 114 patients with NSCLC treated with either ABCP (n = 48) or PC (n = 66) post-TKI failure between November 2016 and July 2023. Treatment response, progression-free survival (PFS), overall survival (OS), and safety profiles were assessed.
RESULTS: Among 106 evaluable participants, the ABCP arm demonstrated a higher response rate (50.0%) than the PC arm (35.0%). During the median follow-up of 29.9 months, PFS was significantly prolonged in the ABCP arm compared with that in the PC arm (7.3 vs 3.0 months, respectively; hazard ratio (HR) 0.643; p = 0.026), whereas OS showed no significant difference (p = 0.165). Subgroup analysis revealed notable improvements in PFS (7.2 vs 2.1 months, HR 0.235; p < 0.001) and OS (11.0 vs 4.1 months, HR 0.418; p = 0.001) in patients with three or more metastatic sites.
CONCLUSION: ABCP significantly improved PFS compared with PC in patients with NSCLC that progressed despite prior TKI therapy. An OS benefit was observed in patients with three or more metastatic sites.
OBJECTIVES: We aimed to evaluate and compare the efficacy and safety of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) versus pemetrexed plus carboplatin or cisplatin (PC) in patients with progressive NSCLC harboring EGFR, ALK, or ROS1 alterations after TKI failure.
DESIGN: Multicenter retrospective study.
METHODS: We analyzed 114 patients with NSCLC treated with either ABCP (n = 48) or PC (n = 66) post-TKI failure between November 2016 and July 2023. Treatment response, progression-free survival (PFS), overall survival (OS), and safety profiles were assessed.
RESULTS: Among 106 evaluable participants, the ABCP arm demonstrated a higher response rate (50.0%) than the PC arm (35.0%). During the median follow-up of 29.9 months, PFS was significantly prolonged in the ABCP arm compared with that in the PC arm (7.3 vs 3.0 months, respectively; hazard ratio (HR) 0.643; p = 0.026), whereas OS showed no significant difference (p = 0.165). Subgroup analysis revealed notable improvements in PFS (7.2 vs 2.1 months, HR 0.235; p < 0.001) and OS (11.0 vs 4.1 months, HR 0.418; p = 0.001) in patients with three or more metastatic sites.
CONCLUSION: ABCP significantly improved PFS compared with PC in patients with NSCLC that progressed despite prior TKI therapy. An OS benefit was observed in patients with three or more metastatic sites.