Efficacy of first-line treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) alone or in combination with chemotherapy for advanced non-small cell lung cancer (NSCLC) with low-abundance mutation
Autor: | Xiaojuan Zhang, Xuanxuan Zheng, Jinpo Yang, Peng Li, M. Zhang, Xiangtao Yan, Zhiyong Ma, Huijuan Wang, Guowei Zhang |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male 0301 basic medicine Pulmonary and Respiratory Medicine Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Combination therapy medicine.medical_treatment non-small cell lung cancer (NSCLC) Subgroup analysis Kaplan-Meier Estimate 03 medical and health sciences 0302 clinical medicine Mutation Rate Epidermal growth factor Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Neoplasm Metastasis Adverse effect Protein Kinase Inhibitors Aged Neoplasm Staging Proportional Hazards Models Chemotherapy business.industry Incidence (epidemiology) Middle Aged Prognosis medicine.disease Survival Analysis respiratory tract diseases ErbB Receptors Regimen Treatment Outcome 030104 developmental biology 030220 oncology & carcinogenesis Mutation Female business |
Zdroj: | Lung Cancer. 128:6-12 |
ISSN: | 0169-5002 |
Popis: | Objective: The objective of this study was to investigate whether first-line treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with chemotherapy improves the prognosis of patients with advanced non-small cell lung cancer (NSCLC) who harbour low-abundance EGFR mutations. Patients and methods: We retrospectively analysed the clinical data of 76 patients with advanced NSCLC who harboured low-abundance EGFR mutations. The patients were divided into the combination group and the monotherapy group. The combination group received EGFR-TKI combined with a platinum-based regimen. After the end of chemotherapy, EGFR-TKI was administered daily. The monotherapy group was administered EGFR-TKI therapy daily. Results: No significant difference was observed in response rate between the different groups. The median PFS and OS were significantly longer in the combination group than in the monotherapy group (PFS: 7.9 months [95% CI,5.73–10.07] vs 5.9 months [95% CI, 4.99–6.81], p = 0.015; OS: 25.8 months[95% CI,16.27–35.33] vs 19.8 months [95% CI, 18.60–21.00], p = 0.047). Subgroup analysis showed that, for patients with the exon 21 L858R mutation, the PFS and OS were significantly longer in the combination group than in the monotherapy group (PFS: 7.2 months vs 5.8 months, p = 0.013; OS: 22.0 months vs 18.7 months, p = 0.024). The incidence of adverse events was significantly higher in the combination group. Conclusion: For patients with advanced NSCLC and low-abundance EGFR mutations, first-line treatment with EGFR-TKI plus chemotherapy significantly improved PFS and OS. The combination therapy increased the incidence of adverse reactions, but all adverse reactions were expected and tolerated. |
Databáze: | OpenAIRE |
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