2023 World Conference on Lung Cancer (Posters)-EP11.03. Anti-angiogenic Therapy or Immunotherapy? A Multicenter Study of Patients with Advanced NSCLC with EGFR / HER2 exon 20 Insertion Mutations

EP11.03. Anti-angiogenic Therapy or Immunotherapy? A Multicenter Study of Patients with Advanced NSCLC with EGFR / HER2 exon 20 Insertion Mutations - PDF(Abstract)

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This research study evaluated the efficacy of different treatment methods for patients with advanced non-small cell lung cancer (NSCLC) who have EGFR/HER2 exon 20 insertion mutations. The standard treatment for these patients is platinum-containing double-drug chemotherapy, as first-generation TKIs have limited effectiveness against these mutations. The study aimed to explore new treatment options by combining immunotherapy or anti-angiogenic therapy with chemotherapy.<br /><br />The researchers reviewed patients treated at Shanghai Chest Hospital and Shanghai Pulmonary Hospital from 2015 to 2022. They assessed the objective response rate (ORR) and disease control rate (DCR) of patients receiving chemotherapy, anti-angiogenic therapy, and immunotherapy. They also compared progression-free survival (PFS) and overall survival (OS) among the different treatment approaches.<br /><br />Out of the 126 patients included in the study, 51 had EGFR exon 20 insertion mutations and 75 had HER2 exon 20 insertion mutations. In the first-line treatment, the combination of bevacizumab chemotherapy (BevaChemo) and immunotherapy with chemotherapy (ICIChemo) showed better efficacy compared to chemotherapy alone in terms of ORR, DCR, and median PFS. Stratified analysis revealed that ICIChemo was more effective for EGFR exon 20 insertion mutations, while BevaChemo was more effective for HER2 exon 20 insertion mutations.<br /><br />In the second-line treatment for EGFR exon 20 insertion mutations, bevacizumab chemotherapy demonstrated a significant advantage in PFS compared to targeted therapy.<br /><br />In conclusion, ICIChemo showed a significant improvement in PFS for patients with EGFR exon 20 insertion mutations. Additionally, bevacizumab combined with chemotherapy was more effective than targeted therapy after chemotherapy progression. For patients with HER2 exon 20 insertion mutations, BevaChemo was a better treatment choice.<br /><br />This study provides insight into the potential benefits of combining immunotherapy or anti-angiogenic therapy with chemotherapy for patients with EGFR/HER2 exon 20 insertion mutations in advanced NSCLC.

Asset Subtitle

Tianqing Chu

Meta Tag

Speaker Tianqing Chu

Topic Metastatic NSCLC: Immunotherapy - Retrospective

Keywords

treatment methods

advanced NSCLC

EGFR/HER2 exon 20 insertion mutations

chemotherapy

immunotherapy

anti-angiogenic therapy

progression-free survival

overall survival

bevacizumab chemotherapy

targeted therapy