Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea.
Lung Cancer. 2024 Apr;190:107509. doi: 10.1016/j.lungcan.2024.107509. Epub 2024 Feb 20.
This analysis of the first-line cohort of LASER201 study evaluated the efficacy and safety of lazertinib 240 mg as a frontline therapy for epidermal growth factor receptor (EGFR)-mutated locally advanced or metastatic non-small cell lung cancer (NSCLC).
A total of 43 patients, with EGFR mutation-positive (Exon19Del, n = 24; L858R, n = 18; G719X, n = 1) locally advanced or metastatic NSCLC who had not previously received EGFR tyrosine kinase inhibitor (EGFR TKI) therapy, received once-daily lazertinib 240 mg. EGFR mutation status was confirmed by local or central testing. The primary endpoint was objective response rate (ORR) assessed by blinded independent central review. Secondary efficacy endpoints included duration of response (DoR), disease control rate (DCR), progression-free survival (PFS), tumor shrinkage, and overall survival (OS).
At the primary data cut-off (DCO; January 8, 2021), the ORR was 70 % (95 % confidence interval [CI]: 56.0-83.5), DCR was 86 % (95 % CI: 75.7-96.4) and the median DoR was 23.5 (95 % CI: 12.5-not reached) months. The median PFS was 24.6 (95 % CI: 12.2-30.2) months. At the final DCO (March 30, 2023), the median OS was not estimable and the median follow-up duration for OS was 55.2 [95 % CI: 22.8-55.7] months. OS rates at 36 months and 54 months were 66 % (95 % CI: 47.5-79.3 %) and 55 % (95 % CI: 36.6-70.7 %), respectively. The most commonly reported TEAEs were rash (54 %), diarrhea (47 %), pruritus (35 %), and paresthesia (35 %). No drug-related rash or pruritus TEAEs of grade 3 or higher were reported. Diarrhea and paresthesia of grade 3 or higher were reported in 3 (7 %) and 1 (2 %) patients, respectively.
This analysis demonstrated long-term clinical benefit with lazertinib 240 mg in patients with EGFR-mutated NSCLC who had not previously received EGFR TKIs. The safety profile for lazertinib was tolerable and consistent with that previously reported.
本分析评估了 LASER201 研究一线队列中, lazertinib 240mg 作为表皮生长因子受体(EGFR)突变局部晚期或转移性非小细胞肺癌(NSCLC)一线治疗的疗效和安全性。
43 名从未接受过 EGFR 酪氨酸激酶抑制剂(EGFR TKI)治疗的局部晚期或转移性 EGFR 突变阳性(外显子 19 缺失,n=24;L858R,n=18;G719X,n=1)非小细胞肺癌患者,接受 lazertinib 240mg 每日一次治疗。EGFR 突变状态通过局部或中心检测确认。主要终点为盲法独立中心评估的客观缓解率(ORR)。次要疗效终点包括缓解持续时间(DoR)、疾病控制率(DCR)、无进展生存期(PFS)、肿瘤缩小和总生存期(OS)。
在主要数据截止日期(DCO;2021 年 1 月 8 日),ORR 为 70%(95%CI:56.0-83.5),DCR 为 86%(95%CI:75.7-96.4),中位 DoR 为 23.5 个月(95%CI:12.5-未达到)。中位 PFS 为 24.6 个月(95%CI:12.2-30.2)。在最终的 DCO(2023 年 3 月 30 日),中位 OS 无法估计,OS 的中位随访时间为 55.2 个月(95%CI:22.8-55.7)。36 个月和 54 个月的 OS 率分别为 66%(95%CI:47.5-79.3%)和 55%(95%CI:36.6-70.7%)。最常见的 TEAEs 为皮疹(54%)、腹泻(47%)、瘙痒(35%)和感觉异常(35%)。未报告与药物相关的 3 级或以上皮疹或瘙痒 TEAEs。腹泻和感觉异常的 3 级或以上 TEAEs分别为 3 例(7%)和 1 例(2%)。
本分析显示, lazertinib 240mg 可为未接受过 EGFR TKI 治疗的 EGFR 突变型 NSCLC 患者带来长期临床获益。lazertinib 的安全性可耐受,与先前报道一致。