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The Glasgow Prognostic Score Predicts Survival in Patients with Advanced Non-Small Cell Lung Cancer Harboring
Yuki Akazawa1, Satoshi Igawa1, Kaori Yamada1
1Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Introduction:
Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are the standard first-line treatment for advanced non-small cell lung cancer (NSCLC) with sensitive EGFR mutations. The Glasgow prognostic score (GPS) is an inflammation-assessing score based on C-reactive protein and albumin concentrations. Information regarding the association between the GPS and EGFR-TKI treatment effectiveness is limited; hence, we investigated whether the GPS can predict the response of NSCLC to EGFR-TKIs.
Methods:
We evaluated 340 patients with NSCLC harboring sensitive EGFR mutations who received EGFR-TKI monotherapy between March 2009 and July 2021. The Kaplan-Meier method and Cox proportional hazards models were used to assess progression-free survival (PFS) and overall survival (OS).
Results:
After a median follow-up of 26.6 months, patients with a GPS of 0, 1, and 2 had PFS of 15.7, 10.0, and 6.3 months, respectively, and OS of 40.1, 25.8, and 14.4 months, respectively; patients with a GPS of 0 had significantly better PFS and OS than those with a GPS of 1 (p = 0.03, p = 0.001, respectively) or 2 (p < 0.001, p < 0.001, respectively). Multivariate analysis identified poor performance status, stage 4 at diagnosis, type of EGFR-TKI (gefitinib/erlotinib vs. afatinib), and GPS = 2 as predictors of a short PFS. Meanwhile, poor performance status, gefitinib/erlotinib administration, and GPS = 2 were predictors of a short OS.
Conclusion:
The GPS predicted the survival of NSCLC patients harboring sensitive EGFR mutations who were undergoing EGFR-TKI treatment. The GPS might be ideal for routine use in clinical practice, given that it is an easily calculated parameter.
Insights
The Glasgow prognostic score (GPS) effectively predicts survival outcomes for advanced non-small cell lung cancer (NSCLC) patients treated with epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs). A lower GPS indicates better progression-free survival (PFS) and overall survival (OS) in NSCLC patients receiving EGFR-TKI therapy.
Area of Science:
- Oncology
- Medical Diagnostics
- Pharmacology
Background:
- Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) are standard first-line therapy for advanced non-small cell lung cancer (NSCLC) with EGFR mutations.
- The Glasgow prognostic score (GPS) assesses systemic inflammation using C-reactive protein and albumin levels.
- Limited data exists on the association between GPS and EGFR-TKI treatment efficacy in NSCLC.
Purpose of the Study:
- To investigate the predictive value of the Glasgow prognostic score (GPS) for treatment response in NSCLC patients receiving EGFR-TKIs.
- To evaluate the association between GPS and progression-free survival (PFS) and overall survival (OS) in this patient cohort.
Main Methods:
- Retrospective analysis of 340 NSCLC patients with sensitive EGFR mutations treated with EGFR-TKI monotherapy.
- Patient data collected between March 2009 and July 2021.
- Progression-free survival (PFS) and overall survival (OS) assessed using Kaplan-Meier method and Cox proportional hazards models.
Main Results:
- Patients with GPS of 0 demonstrated significantly longer PFS (15.7 months) and OS (40.1 months) compared to those with GPS of 1 or 2.
- A GPS of 2 was a significant predictor of shorter PFS and OS.
- Multivariate analysis identified poor performance status, stage 4 diagnosis, specific EGFR-TKI type, and GPS=2 as predictors of poor survival.
Conclusions:
- The Glasgow prognostic score (GPS) is a valuable predictor of survival in NSCLC patients treated with EGFR-TKIs.
- The GPS is easily calculable and may be suitable for routine clinical use.
- Integrating GPS assessment can aid in stratifying NSCLC patients for EGFR-TKI therapy.
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