EGFR-TKI plus bevacizumab versus EGFR-TKI monotherapy for patients with EGFR mutation-positive advanced non-small cell lung cancer-A propensity score matching analysis
Autor: | Yi Ting Yen, Wu Chou Su, Chao Chun Chang, Po Lan Su, Chien Chung Lin, Wu Wei Lai, Chia Ying Lin, Jeng Shiuan Tsai, Szu Chun Yang, Yau Lin Tseng |
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Rok vydání: | 2021 |
Předmět: |
Oncology
Medicine (General) medicine.medical_specialty Lung Neoplasms Bevacizumab Combination therapy Subgroup analysis NSCLC 03 medical and health sciences R5-920 0302 clinical medicine Carcinoma Non-Small-Cell Lung Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Epidermal growth factor receptor Propensity Score Lung cancer Protein Kinase Inhibitors Retrospective Studies biology business.industry Hazard ratio General Medicine medicine.disease TKI respiratory tract diseases ErbB Receptors 030220 oncology & carcinogenesis Mutation Propensity score matching biology.protein 030211 gastroenterology & hepatology Erlotinib EGFR mutation business medicine.drug |
Zdroj: | Journal of the Formosan Medical Association, Vol 120, Iss 9, Pp 1729-1739 (2021) |
ISSN: | 0929-6646 |
Popis: | Background Recent study showed that the combination of erlotinib and bevacizumab had better disease control than erlotinib monotherapy in patients with advanced epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). However, there is lack of real-world evidence for this therapeutic regimen. We aimed to compare outcomes between patients with EGFR mutant NSCLC treated with EGFR-tyrosine kinase inhibitors (TKI) and bevacizumab and those treated with EGFR-TKI alone in a real-world setting. Methods Patients with advanced EGFR-mutant NSCLC who received first-line EGFR-TKI in a tertiary referral center from October 1, 2013 to December 31, 2019 were retrospectively analyzed. We performed 1:2 propensity score-matching: one EGFR-TKI and bevacizumab recipient with two patients who received EGFR-TKI alone. Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan–Meier method. The prognostic factors were analyzed using Cox proportional hazards regression analysis. Results Total 313 patients were enrolled. After propensity score matching, 45 patients who received first-line EGFR-TKI and bevacizumab and 89 patients who received EGFR-TKI alone were analyzed. The combination group showed improved PFS (17.0 vs. 11.0 months; hazard ratio [HR] = 0.48; p = 0.002) compared to the monotherapy group. In subgroup analysis of patients with an L858R mutation, the combination group showed longer PFS (23.1 vs. 10.7 months; HR = 0.40; p = 0.011) and OS (not reached vs. 40.6 months; HR = 0.27; p = 0.040) than the EGFR-TKI monotherapy group. Conclusion Our data suggest that the combination of EGFR-TKI and bevacizumab could improve PFS in patients with EGFR-mutant NSCLC. In patients harboring L858R mutation, the combination therapy provides better OS than TKI alone. |
Databáze: | OpenAIRE |
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