The prognostic role of EGFR-TKIs for patients with advanced non-small cell lung cancer
Dan Zhao1, Xuejing Chen1, Na Qin2
1Department of Pathology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, China.
Abstract:
Clinical trials have shown that epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) did not improve the survival of patients with EGFR-mutated non-small cell lung cancer (NSCLC) because of the high crossover of treatments. Realistically, the role of EGFR-TKIs in NSCLC with mutated EGFR is not well known. We retrospectively analysed data from patients with recurrent or metastatic NSCLC. Clinical prognostic factors were identified by Cox proportional hazards modelling. Among 503 patients, the median overall survival (OS) for all of patients was 11.7 months. Cox analysis showed that PS 0-1, recurrent disease, EGFR mutations, or EGFR-TKI treatment were associated with improved OS. In patients with EGFR-activating mutations, Cox analysis showed that patients with adenocarcinoma, recurrent disease, or EGFR-TKI treatment had significantly longer survival. Patients with EGFR-activating mutations who received EGFR-TKI therapy had a median OS of 24.3 months, which was significantly longer than those who had not received EGFR-TKI therapy (10.8 months). Patients with wild-type EGFR had a median OS of 9.7 months and Cox analysis showed that PS score and disease type were independent predictors. EGFR-TKI therapy is an independently prognostic factor for NSCLC with mutated EGFR. A more effective therapy is needed for patients with wild-type EGFR.
Insights
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) significantly improve survival for non-small cell lung cancer (NSCLC) patients with EGFR mutations. Patients with wild-type EGFR require more effective treatments.
Area of Science:
- Oncology
- Medical Research
Background:
- Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) effectiveness in EGFR-mutated non-small cell lung cancer (NSCLC) is unclear due to treatment crossover in clinical trials.
- The prognostic role of EGFR-TKIs in NSCLC with EGFR mutations requires further investigation.
Purpose of the Study:
- To retrospectively analyze the survival outcomes of patients with recurrent or metastatic non-small cell lung cancer (NSCLC).
- To identify clinical prognostic factors and evaluate the impact of EGFR-TKIs on overall survival (OS) in NSCLC patients with and without EGFR mutations.
Main Methods:
- Retrospective analysis of data from 503 patients with recurrent or metastatic NSCLC.
- Cox proportional hazards modeling was used to identify clinical prognostic factors associated with overall survival (OS).
Main Results:
- Median overall survival (OS) for all patients was 11.7 months.
- EGFR-TKI treatment was associated with improved OS in patients with EGFR-activating mutations (24.3 months vs. 10.8 months).
- Patients with wild-type EGFR had a median OS of 9.7 months, with PS score and disease type as independent predictors.
Conclusions:
- EGFR-TKI therapy is an independent prognostic factor for improved survival in NSCLC patients with EGFR mutations.
- Novel therapeutic strategies are needed for non-small cell lung cancer patients with wild-type EGFR.
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