Contrary to Pemetrexed-containing chemo-immunotherapy studies, Atezolizumab, Bevacizumab, Carboplatin, and Paclitaxel (ABCP) treatment has consistently shown clinical benefit in prospective studies in patients with lung cancer and actionable mutations, where intracranial metastases are common. Here, we aimed to describe the real-life population of patients fit to receive ABCP after targeted therapy and quantify its clinical effect in patients with brain metastases. Patients treated in Cheshire and Merseyside between 2019 and 2022 were identified. Data were collected retrospectively. A total of 34 patients with actionable EGFR or ALK alterations had treatment with a median age of 59 years (range 32–77). The disease control rate was 100% in patients with PDL1 ≥ 1% (n= 10). In total, 19 patients (56%) had brain metastases before starting ABCP, 17 (50%) had untreated CNS disease, and 4 (22%) had PDL1 ≥ 1%. The median time to symptom improvement was 12.5 days (range 4–21 days), with 74% intracranial disease control rates and 89.5% synchronous intracranial (IC) and extracranial (EC) responses. IC median Progression Free Survival (mPFS) was 6.48 months, EC mPFS was 10.75 months, and median Overall Survival 11.47 months. ABCP in real-life patients with brain metastases (treated or untreated) was feasible and showed similar efficacy to that described in patients without actionable mutations treated with upfront chemo-immunotherapy.
与含培美曲塞的化疗免疫治疗研究不同，阿特珠单抗、贝伐珠单抗、卡铂和紫杉醇（ABCP）联合治疗方案在前瞻性研究中持续显示出对携带可作用突变且常见颅内转移的肺癌患者的临床获益。本研究旨在描述靶向治疗后适合接受ABCP治疗的真实世界患者群体特征，并量化该方案对脑转移患者的临床疗效。我们回顾性收集了2019年至2022年间在柴郡和默西塞德郡接受治疗的患者数据。共纳入34例携带EGFR或ALK可作用突变的患者，中位年龄59岁（范围32-77岁）。在PD-L1表达≥1%的患者（n=10）中疾病控制率达到100%。总体而言，19例患者（56%）在开始ABCP治疗前存在脑转移，其中17例（50%）存在未经治疗的CNS病灶，4例（22%）患者PD-L1表达≥1%。症状改善的中位时间为12.5天（范围4-21天），颅内疾病控制率达74%，颅内（IC）与颅外（EC）病灶同步缓解率达89.5%。颅内中位无进展生存期（mPFS）为6.48个月，颅外mPFS为10.75个月，中位总生存期为11.47个月。在真实世界脑转移患者（无论是否经过治疗）中应用ABCP方案具有可行性，其疗效与前期化疗免疫治疗用于无基因突变患者的研究结果相当。
肿瘤(癌症)患者之家