携带 ROS1 重排的非小细胞肺癌 (NSCLC) 是一个分子亚型，对酪氨酸激酶抑制剂 (TKI) 治疗的反应优于化疗。本研究调查了 ROS1 重排的晚期 NSCLC 患者的真实治疗模式和生存结果。我们对 2018 年 8 月至 2022 年 3 月在中国四家不同医院治疗的 ROS1 重排的晚期 NSCLC 患者进行了回顾性分析。该研究分析了基因融合分布、耐药模式和生存结果。ROS1 重排发生在我们研究队列的 1.8% (550/31,225) 中。 CD74 是最常见的 ROS1 融合伴侣，占 45.8%。 73.9% 的患者在一线治疗中使用克唑替尼，在二线治疗中化疗、色瑞替尼和劳拉替尼的使用有所增加。肺（43.2%）和脑（27.6%）是一线治疗中最常见的进展部位，而脑进展（39.2%）是二线治疗中最常见的进展部位。中位总生存期为 46 个月（95% 置信区间：39.6-52.4）。在无进展生存期（18.5 vs. 6.0；p < 0.001）和总生存期（49.8 vs. 37；p = 0.024）方面，一线使用克唑替尼的生存结果显着优于化疗。后一线治疗的选择也对生存有影响，其中一线克唑替尼随后序贯 TKI 治疗比一线化疗随后 ​​TKI 治疗的生存结果更好。我们的研究提供了对现实世界治疗的见解， ROS1 重排 NSCLC 患者的耐药模式和生存结果。该信息可作为指导 NSCLC 分子亚型治疗的宝贵参考。版权所有 © 2024 Elsevier B.V. 保留所有权利。

Non-small cell lung cancer (NSCLC) harboring ROS1 rearrangements is a molecular subset that exhibits favorable responses to tyrosine kinase inhibitor (TKI) treatment than chemotherapy. This study investigated real-world treatment patterns and survival outcomes among patients with ROS1-rearranged advanced NSCLC.We conducted a retrospective analysis of patients with ROS1-rearranged advanced NSCLC treated in four different hospitals in China from August 2018 to March 2022. The study analyzed gene fusion distribution, resistance patterns, and survival outcomes.ROS1 rearrangement occurs in 1.8 % (550/31,225) of our study cohort. CD74 was the most common ROS1 fusion partner, accounting for 45.8 %. Crizotinib was used in 73.9 % of patients in the first-line treatment, and an increased use of chemotherapy, ceritinib, and lorlatinib was seen in the second-line setting. Lung (43.2 %) and brain (27.6 %) were the most common sites of progression in first-line setting, while brain progression (39.2 %) was the most common site of progression in second-line. Median overall survival was 46 months (95 % confidence intervals: 39.6-52.4). First-line crizotinib use yielded significantly superior survival outcomes over chemotherapy in terms of progression-free (18.5 vs. 6.0; p < 0.001) and overall survival (49.8 vs. 37; p = 0.024). The choice of treatment in the latter line also had survival implications, wherein survival outcomes were better when first-line crizotinib was followed by sequential TKI therapy than first-line chemotherapy followed by TKI therapy.Our study provided insights into the real-world treatment, drug resistance patterns, and survival outcomes among patients with ROS1-rearranged NSCLC. This information serves as a valuable reference for guiding the treatment of this molecular subset of NSCLC.Copyright © 2024 Elsevier B.V. All rights reserved.