Clinical Predictive Factors associated with First Line EGFR-TKI Efficacy
in Advanced NSCLC Patients with EGFR Mutations.
10.3779/j.issn.1009-3419.2019.02.04
- Author:
Minjiang CHEN
1
;
Yan XU
1
;
Jing ZHAO
1
;
Wei ZHONG
1
;
Mengzhao WANG
1
Author Information
1. Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
Epidermal growth factor receptor tyrosine kinase inhibitors;
Lung neoplasms;
Predictive factor
- MeSH:
Adult;
Aged;
Antineoplastic Agents;
administration & dosage;
Carcinoma, Non-Small-Cell Lung;
drug therapy;
enzymology;
genetics;
mortality;
ErbB Receptors;
genetics;
metabolism;
Female;
Humans;
Lung Neoplasms;
drug therapy;
enzymology;
genetics;
Middle Aged;
Mutation;
Protein Kinase Inhibitors;
administration & dosage;
Retrospective Studies;
Treatment Outcome;
Young Adult
- From:
Chinese Journal of Lung Cancer
2019;22(2):99-104
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated some dramatic efficacy in advanced non-small-cell lung cancer (NSCLC) patients with activating EGFR mutation. However, progression-free survivals (PFS) among those patients who were treated with first line EGFR TKIs were inconsistent. The aim of this study is to explore the association of clinical prognostic factors with EGFR-TKI efficacy in advanced NSCLC patients.
METHODS:The demographic and clinical characteristics of 203 patients with activating EGFR mutation treated with first generation TKI as a first-line therapy were retrospectively reviewed.
RESULTS:Of the 203 patients enrolled in this study, 139 patients had progression of disease and 63 patients died. The subjects had a median follow up duration of 21.1months and a median PFS of 14.3 months. Partial response (PR) was achieved in 127 (66.1%) patients and stable disease (SD) rate was achieved in 55 (28.6%) patients. In univariate analysis, patients with 2 or higher ECOG score (5.1 vs 16 months, P=0.033), SD as best overall response (9.5 vs 17.9 months, P=0.030), extrathoracic metastasis (11.7 vs 27.5 months, P=0.004), liver metastasis (4.1 vs 16.0 months, P=0.000), bone metastasis (13.3 vs 21.5months, P=0.027) and pulmonary embolism (5.5 vs 16.6 months, P=0.005) had shorter PFS than those without the listed factors. Multivariable Cox regression analysis showed best overall response (HR=1.825, 95%CI: 1.107-3.008, P=0.018) and liver metastasis (HR=1.694, 95%CI: 1.146-5.756, P=0.022) were independent predictive factors of shorter PFS.
CONCLUSIONS:Despite the high efficacy of EGFR-TKI, SD as best overall response and liver metastasis predicts poorer PFS in advanced NSCLC patients with EGFR gene mutations receiving first-line therapy treatment.
