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Yang S, Wu S, Zhao Y, Chen G, Zhu B, Li X, Wang K, Shi J, Cang S, Yao W, Fan Y, Fang J, Zhang L, Zhou J, Wu L, Zheng R, Huang M, Pan Y, Yang Z, Sun M, Yu H, Wang D, Huang J, Wang L, Shu Y, Chen Z, Liu C, Li J, Liu J, Sun S, Guo Y, Meng Z, Liu Z, Han Z, Wu G, Lu H, Ma R, Hu S, Zhao G, Zhang L, Liu Z, Xie C, Zhong D, Zhao H, Bi M, Yi S, Guo S, Yi T, Li W, Lin Y, Chen Z, Zhuang Z, Guo Z, Greco M, Wang T, Zhou A, Shi Y. Central nervous system efficacy of rezivertinib (BPI-7711) in advanced NSCLC patients with EGFR T790M mutation: A pooled analysis of two clinical studies. Lung Cancer 2023; 180:107194. [PMID: 37163774 DOI: 10.1016/j.lungcan.2023.107194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/11/2023] [Accepted: 04/13/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Rezivertinib (BPI-7711) is a novel third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) which revealed the systematic and central nervous system (CNS) antitumor activities for EGFR T790M-mutated advanced NSCLC in previous clinical studies and is further analyzed here. METHODS Eligible patients from the previous phase I and phase IIb studies of rezivertinib were included for pooled analysis. Post-progressive patients who received a prescribed dosage (≥180 mg) of rezivertinib orally once daily were included in full analysis set (FAS), while those with stable, asymptomatic CNS lesions, including measurable and non-measurable ones at baseline were included in CNS full analysis set (cFAS). Patients with measurable CNS lesions were included in CNS evaluable for response set (cEFR). BICR-assessed CNS objective response rate (CNS-ORR), CNS disease control rate (CNS-DCR), CNS duration of response (CNS-DoR), CNS progression-free survival (CNS-PFS), and CNS depth of response (CNS-DepOR) were evaluated. RESULTS 355 patients were included in FAS, among whom 150 and 45 patients were included in cFAS and cEFR. This pooled analysis showed the CNS-ORR was 32.0% (48/150; 95% CI: 24.6-40.1%) and the CNS-DCR was 42.0% (63/150; 95% CI: 34.0-50.3%) in cFAS, while that in cEFR were 68.9% (31/45; 95% CI: 53.4-81.8%) and 100% (45/45; 95% CI: 92.1-100.0%). In cEFR, the median CNS-DepOR and the mean of CNS-DepOR were -52.0% (range: -100.0 to 16.1%) and -46.8% (95% CI: -55.5 to -38.1%). In cFAS, the median CNS-DoR and CNS-PFS were 13.8 (95% CI: 9.6-not calculable [NC]) and 16.5 (95% CI: 13.7-NC) months. CONCLUSIONS Rezivertinib demonstrated encouraging clinical CNS efficacy among advanced NSCLC patients with EGFR T790M mutation and CNS metastases.
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Affiliation(s)
- Sheng Yang
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, People's Republic of China
| | - Shiman Wu
- Department of Respiratory Medicine, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Yanqiu Zhao
- Department of Respiratory Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Gongyan Chen
- Department of Respiratory Medicine, Harbin Medical University Cancer Hospital, Harbin, People's Republic of China
| | - Bo Zhu
- Department of Oncology, Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing, People's Republic of China
| | - Xingya Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Ke Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Jianhua Shi
- Department of Medical Oncology, Linyi Cancer Hospital, Linyi, People's Republic of China
| | - Shundong Cang
- Department of Medical Oncology, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Wenxiu Yao
- Department of Medical Oncology, Sichuan Cancer Hospital, Chengdu, People's Republic of China
| | - Yun Fan
- Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China
| | - Jian Fang
- Department of Thoracic Oncology, Beijing Cancer Hospital, Beijing, People's Republic of China
| | - Liangming Zhang
- Department of Medical Oncology, Yantai Yuhuangding Hospital, Yantai, People's Republic of China
| | - Jianying Zhou
- Department of Respiratory Medicine, The First Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, People's Republic of China
| | - Lin Wu
- Department of Thoracic Medical Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, People's Republic of China
| | - Rongsheng Zheng
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People's Republic of China
| | - Meijuan Huang
- Thoracic Oncology Ward, Division of Medical Oncology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yueyin Pan
- Department of Thoracic Cancer Chemotherapy, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Zhixiong Yang
- Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
| | - Meili Sun
- Department of Oncology, Jinan Central Hospital Shandong University, Jinan, People's Republic of China
| | - Huiqing Yu
- Department of Palliative Care, Department of Geriatric Oncology, Chongqing University Cancer Hospital, Chongqing, People's Republic of China
| | - Donglin Wang
- Department of Palliative Care, Department of Geriatric Oncology, Chongqing University Cancer Hospital, Chongqing, People's Republic of China
| | - Jianan Huang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Lijun Wang
- Cancer Center, The Second Affiliated Hospital of Xingtai Medical College, Xingtai, People's Republic of China
| | - Yongqian Shu
- Department of Oncology, Jiangsu Province Hospital, Nanjing, People's Republic of China
| | - Zhaohong Chen
- Department of Oncology, People's Hospital of Deyang City, Deyang, People's Republic of China
| | - Chunling Liu
- Pulmonary Cancer Medicine, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Jingzhang Li
- Department of Oncology, Liuzhou People's Hospital, Liuzhou, People's Republic of China
| | - Jiwei Liu
- Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, People's Republic of China
| | - Shenghua Sun
- Department of Respiratory Medicine, Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Yanzhen Guo
- Department of Medical Oncology, The First Affiliated Hospital of Henan University of Science & Technology, Luoyang, People's Republic of China
| | - Zili Meng
- Department of Respiratory Medicine, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huaian, People's Republic of China
| | - Zhefeng Liu
- Department of Oncology, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Zhigang Han
- Pulmonary Cancer Medicine, Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, People's Republic of China
| | - Gang Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Hong Lu
- Department of Oncology, Huaihe Hospital of Henan University, Kaifeng, People's Republic of China
| | - Rui Ma
- Department of Thoracic Oncology, Liaoning Cancer Hospital & Institute, Shenyang, People's Republic of China
| | - Sheng Hu
- Department of Thoracic Oncology, Hubei Cancer Hospital, Wuhan, People's Republic of China
| | - Guofang Zhao
- Department of Thoracic Surgery, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, People's Republic of China
| | - Longzhen Zhang
- Department of Radiotherapy, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, People's Republic of China
| | - Zheng Liu
- Department of Oncology, HanDan Central Hospital, Handan, People's Republic of China
| | - Congying Xie
- Department of Radiotherapy, The 1st Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Diansheng Zhong
- Department of Medical Oncology, Tianjin Medical University General Hospital, Tianjin, People's Republic of China
| | - Hui Zhao
- Department of Respiratory Medicine, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Minghong Bi
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People's Republic of China
| | - Shanyong Yi
- Department of Medical Oncology, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, People's Republic of China
| | - Shuliang Guo
- Department of Respiratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Tienan Yi
- Department of Oncology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Sciences, Xiangyang, People's Republic of China
| | - Wen Li
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital Zhejiang University School of Medicine. Hangzhou, People's Republic of China
| | - Yingcheng Lin
- Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Zhendong Chen
- Department of Oncology, The Second Hospital of Anhui Medical University, Hefei, People's Republic of China
| | - Zhixiang Zhuang
- Department of Oncology, The Second Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Zhongliang Guo
- Department of Respiratory Medicine, Shanghai East Hospital, Shanghai, People's Republic of China
| | - Michael Greco
- Department of Drug Discovery, Beta Pharma Inc., Princeton, NJ, USA
| | - Tingting Wang
- Department of Clinical Development, Beta Pharma (Shanghai) Co., Ltd., Shanghai, People's Republic of China
| | - Anqi Zhou
- Department of Clinical Development, Beta Pharma (Shanghai) Co., Ltd., Shanghai, People's Republic of China
| | - Yuankai Shi
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, Beijing, People's Republic of China.
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