在俄罗斯医疗系统内增加治疗非小细胞肺癌患者的创新疗法的可用性的当前问题

K. Laktionov, S. Zyryanov, E. Artamonova, A. V. Smolin, E. Reutova, M. V. Zhuravleva, A. Kolbin, M. Y. Frolov
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摘要

咨询委员会讨论了对 MET 基因突变的晚期非小细胞肺癌(METex14 非小细胞肺癌)的诊断和治疗现状。在俄罗斯,肺癌在肿瘤疾病中占主导地位。MET 酪氨酸激酶抑制剂卡马替尼的疗效在 GEOMETRY mono-1 登记试验中得到了证实:既往接受过 1-2 线治疗的 METex14 非小细胞肺癌患者的客观反应率为 41%,既往未接受过治疗的患者的客观反应率为 68%。既往接受过 METex14 治疗的 aNSCLC 患者的中位应答持续时间为 9.7 个月,未接受过 METex14 治疗的 aNSCLC 患者的中位应答持续时间为 12.6 个月。在使用 METex14 的 aNSCLC 患者中,54% 的病例出现了颅内反应。此外,在现实世界的临床实践中,卡马替尼对患有METex14的aNSCLC患者的疗效也得到了证实。根据卡马替尼的有效性和耐受性数据,专家组决定建议将卡马替尼纳入《俄罗斯肺癌治疗临床指南》和基本药物清单。
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Current issues of increasing the availability of innovative therapy for the treatment of patients with non-small cell lung cancer within the Russian healthcare system
The advisory board was held to discuss he current situation with diagnosis and treatment of advanced non — small cell lung cancer with a mutation in the MET gene (aNSCLC with METex14). Lung cancer takes a leading place in the structure of oncological diseases in Russia. The frequency of molecular abnormalities in the MET gene patients with advanced lung cancer is 3%, the NGS method is the most effective in identifying this alteration.The effectiveness of capmatinib, a MET tyrosine kinase inhibitor was confirmed in the GEOMETRY mono-1 registry trial: the objective response rate in the patients with aNSCLC with METex14 who had previously received 1–2 lines of therapy was 41%, among those who had not previously received treatment — 68%. Median duration of response was 9.7 month in previously treated patients with aNSCLC with METex14 and 12.6 months in the treatment — naïve patients with aNSCLC with METex14. Intracranial response was observed in 54% of cases among patients with aNSCLC with METex14. In addition, the efficacy of capmatinib was confirmed when it is administered to the patients with aNSCLC with METex14 in real-world clinical practice. Other therapeutic options (immune-oncology therapy, chemotherapy) are less effective in case of this disease variant.Based on the data on effectiveness and tolerability of capmatinib, the expert group made a decision to recommend inclusion of capmatinib in the Russian Clinical Guidelines for the treatment of lung cancer and into the Essential Drug list.
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