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[Clinical Predictive Factors associated with First Line EGFR-TKI Efficacy in Advanced NSCLC Patients with EGFR
Minjiang Chen1, Yan Xu1, Jing Zhao1
1Department of Respiratory Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Background:
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated some dramatic efficacy in advanced non-small-cell lung cancer (NSCLC) patients with activating EGFR mutation. However, progression-free survivals (PFS) among those patients who were treated with first line EGFR TKIs were inconsistent. The aim of this study is to explore the association of clinical prognostic factors with EGFR-TKI efficacy in advanced NSCLC patients.
Methods:
The demographic and clinical characteristics of 203 patients with activating EGFR mutation treated with first generation TKI as a first-line therapy were retrospectively reviewed.
Results:
Of the 203 patients enrolled in this study, 139 patients had progression of disease and 63 patients died. The subjects had a median follow up duration of 21.1months and a median PFS of 14.3 months. Partial response (PR) was achieved in 127 (66.1%) patients and stable disease (SD) rate was achieved in 55 (28.6%) patients. In univariate analysis, patients with 2 or higher ECOG score (5.1 vs 16 months, P=0.033), SD as best overall response (9.5 vs 17.9 months, P=0.030), extrathoracic metastasis (11.7 vs 27.5 months, P=0.004), liver metastasis (4.1 vs 16.0 months, P=0.000), bone metastasis (13.3 vs 21.5months, P=0.027) and pulmonary embolism (5.5 vs 16.6 months, P=0.005) had shorter PFS than those without the listed factors. Multivariable Cox regression analysis showed best overall response (HR=1.825, 95%CI: 1.107-3.008, P=0.018) and liver metastasis (HR=1.694, 95%CI: 1.146-5.756, P=0.022) were independent predictive factors of shorter PFS.
Conclusions:
Despite the high efficacy of EGFR-TKI, SD as best overall response and liver metastasis predicts poorer PFS in advanced NSCLC patients with EGFR gene mutations receiving first-line therapy treatment.
Insights
Stable disease as best response and liver metastasis predict shorter progression-free survival in advanced non-small-cell lung cancer (NSCLC) patients treated with EGFR tyrosine kinase inhibitors (TKIs). These factors are crucial for predicting treatment outcomes in EGFR-mutated NSCLC.
Area of Science:
- Oncology
- Medical Research
- Pharmacology
Background:
- Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) show efficacy in advanced non-small-cell lung cancer (NSCLC) with EGFR mutations.
- Treatment outcomes with first-line EGFR-TKIs in advanced NSCLC patients with EGFR mutations are inconsistent.
Purpose of the Study:
- To investigate the association between clinical prognostic factors and EGFR-TKI efficacy in advanced NSCLC patients.
- To identify predictive factors for progression-free survival (PFS) in this patient cohort.
Main Methods:
- Retrospective review of demographic and clinical characteristics of 203 advanced NSCLC patients with activating EGFR mutations receiving first-generation TKI therapy.
- Univariate and multivariable Cox regression analyses were performed to identify predictive factors for PFS.
Main Results:
- Median PFS was 14.3 months; 139 patients experienced disease progression and 63 died.
- Univariate analysis indicated shorter PFS in patients with higher ECOG score, stable disease (SD) as best response, extrathoracic metastasis, liver metastasis, bone metastasis, and pulmonary embolism.
- Multivariable analysis identified best overall response (including SD) and liver metastasis as independent predictors of shorter PFS.
Conclusions:
- Stable disease as best overall response and liver metastasis are associated with poorer PFS in advanced NSCLC patients with EGFR mutations receiving first-line EGFR-TKI therapy.
- These factors can aid in predicting treatment outcomes and guiding therapeutic strategies.
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