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
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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