Efficacy of first generation EGFR-TKIs and chemotherapy as first-line therapy in advanced lung adenocarcinoma patients with uncommon EGFR mutations
10.3760/cma.j.issn.0253-3766.2019.10.012
- VernacularTitle: 第一代表皮生长因子受体酪氨酸激酶抑制剂与含铂化疗一线治疗表皮生长因子受体罕见突变阳性晚期肺腺癌患者的疗效
- Author:
Haixia LI
1
;
Ziqi WANG
1
;
Guowei ZHANG
2
;
Mina ZHANG
2
;
Xuanxuan ZHENG
2
;
Jinbo YANG
2
;
Zhiyong MA
2
;
Huijuan WANG
2
Author Information
1. Department of Respiratory Medicine, Henan Provincial People′s Hospital/People′s Hospital of Zhengzhou University/People′s Hospital of Henan University, Zhengzhou 450003, China
2. Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
- Publication Type:Clinical Trail
- Keywords:
Lung adenocarcinoma;
Epithelial growth factor receptor tyrosine kinase inhibitors;
Uncommon mutation;
Chemotherapy;
Prognosis
- From:
Chinese Journal of Oncology
2019;41(10):783-791
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effects of first generation epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) compared with platinum-based chemotherapy as first-line therapy in advanced lung adenocarcinoma patients with uncommon EGFR mutations.
Methods:Clinical data of 4 276 patients diagnosed as advanced lung adenocarcinoma (ⅢB/Ⅳ) underwent EGFR gene detection at the Affiliated Cancer Hospital of Zhengzhou University from January 2012 to February 2018 were collected and 99 cases with uncommon EGFR mutations were selected. The clinical pathological features, treatment outcomes, treatment options and prognosis after first-line treatment of the 99 cases were analysed and compared with other patients with common EGFR mutations.
Results:The objective response rates of patients with uncommon EGFR mutations receiving EGFR-TKIs or platinum-based chemotherapy were 33.0% and 27.1%, respectively. The disease control rates were 76.5% and 87.5%, respectively. The progression-free survival (PFS) of patients treated with EGFR-TKIs was 7.2 months, significantly superior than 4.9 months of patients receiving chemotherapy (P=0.009). The overall survival of patients treated with EGFR-TKIs was 14.3 months, significantly worse than 20.7 months of patients receiving chemotherapy (P=0.034). Multivariate analysis showed that distant metastases (P=0.001) and smoking history (P=0.013) were independent prognostic factors for OS of lung adenocarcinoma patients with EGFR uncommon mutations.
Conclusions:Compared with chemotherapy, the usage of first generation of EGFR-TKIs as first-line therapy can improve the short-term efficacy of advanced lung adenocarcinoma patients with EGFR uncommon mutations. However, platinum-based chemotherapy shows a longer overall survival.
