1. Efficacy and acquired resistance of EGFR-TKI combined with chemotherapy as first-line treatment for Chinese patients with advanced non-small cell lung cancer in a real-world setting
- Author
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Shidai Jin, Renhua Guo, Fangyan Gao, Liang Chen, Zhihong Zhang, Qianqian Wang, Jingya Zhang, Wen Gao, Fan Lin, Chen Zhang, and Tianyu Qu
- Subjects
0301 basic medicine ,Oncology ,Male ,Cancer Research ,Lung Neoplasms ,medicine.medical_treatment ,T790M ,0302 clinical medicine ,Non-small cell lung cancer ,Surgical oncology ,Carcinoma, Non-Small-Cell Lung ,Antineoplastic Combined Chemotherapy Protocols ,Clinical endpoint ,RC254-282 ,Aged, 80 and over ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Middle Aged ,Progression-Free Survival ,ErbB Receptors ,030220 oncology & carcinogenesis ,Female ,Research Article ,Adult ,medicine.medical_specialty ,China ,First-line treatment ,Subgroup analysis ,03 medical and health sciences ,Internal medicine ,EGFR-TKI ,Genetics ,medicine ,Humans ,Chemotherapy ,Lung cancer ,Adverse effect ,Protein Kinase Inhibitors ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,medicine.disease ,respiratory tract diseases ,Regimen ,030104 developmental biology ,Mutation ,Acquired resistance ,business - Abstract
Background To compare the benefits and explore the cause of acquired resistance of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) and its combination with chemotherapy in advanced non-small-cell lung cancer (NSCLC) patients harboring EGFR mutation in a real-life setting. Methods This retrospective analysis included 117 advanced NSCLC patients with EGFR mutation who underwent next-generation sequencing (NGS) prior to treatment. The combination group included 50 patients who received the regimen of EGFR-TKI combined with chemotherapy, while the EGFR-TKI monotherapy group included 67 patients treated with TKI only. The primary endpoint of this study was progression-free survival (PFS); the secondary endpoints were overall survival (OS), response rate, and toxicity. Results The median PFS was significantly longer in the combination group than in the EGFR-TKI monotherapy group (19.00 months [95% CI, 14.67–23.33] vs. 11.70 months [95% CI, 10.81–12.59], p p = 0.586). Patients in the combination group were more likely to experience adverse events, most of which showed the severity of grade 1 or 2. T790M mutation remains the main reason for acquired resistance, and the frequency of T790M mutation was similar between the two groups (p = 0.898). Conclusions Compared with EGFR-TKI monotherapy, EGFR-TKI combined with chemotherapy significantly improved PFS in advanced NSCLC patients with EGFR mutation, with acceptable toxicity.
- Published
- 2021