Clinical efficacy of Osimertinib combined with Savolitinib as second-line therapy for T790M mutation-positive metastatic NSCLC during EGFR-TKI treatment
Objective To investigate the efficacy and safety of Osimertinib combined with Savolitinib as second-line therapy for T790M mutation-positive metastatic non-small cell lung cancer(NSCLC)during treatment with epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI).Methods A total of 94 patients with metastatic NSCLC with T790M mutation during EGFR-TKI treatment in Ankang People's Hospital from January 2021 to January 2022 were selected.The patients were divided into a study group(47 cases)and a control group(47 cases)by the random number table method.During the treatment period,7 cases were lost to follow-up and 40 cases were enrolled in the study group.In the control group,9 cases were lost to follow-up,and 38 cases were enrolled.In the control group,there were 24 males and 14 females,aged(60.32±5.71)years,with a body mass index(BMI)of(18.06±1.61)kg/m2.There were 27 males and 13 females in the study group,aged(61.05±6.64)years,with a BMI of(18.13±1.54)kg/m2.The control group was treated with Osimertinib,and the study group was treated with Savolitinib on the basis of the control group.After 3 months of treatment,the efficacy and adverse reactions of the two groups were compared.The serum levels of carcinoembryonic antigen(CEA),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),vascular endothelial growth factor(VEGF),and matrix metalloproteinase-9(MMP-9)were compared between the two groups before and after treatment.The median progression-free survival(PFS)and median overall survival(OS)were recorded after 2 years of follow-up.Independent sample t test,paired t test,x2 test,Kaplan-Meier analysis,and Log-rank test were used.Results After treatment,the levels of CEA[(65.30±14.29)μg/L],CYFRA21-1[(1.62±0.69)μg/L],VEGF[(381.04±27.64)ng/L],and MMP-9[(151.98±25.47)μg/L]in the study group were lower than those in the control group[(73.59±16.03)μg/L,(2.57±0.76)μg/L,(396.61±26.51)ng/L,and(169.07±26.54)μg/L],with statistically significant differences(all P＜0.05).The disease control rate[85.00％(34/40)]and objective response rate[62.50％(25/40)]of the study group were higher than those of the control group[65.79％(25/38)and 39.47％(15/38)],with statistically significant differences(both P＜0.05).There was no statistically significant difference in the total incidence of adverse drug reactions between the two groups(P＞0.05).There were statistically significant differences in the PFS and OS between the two groups(both P＜0.05).Conclusion Osimertinib combined with Savolitinib as second-line therapy for metastatic NSCLC with T790M mutation during EGFR-TKI treatment helps to improve the disease control rate and prolong the patients'survival,with good safety.
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