Survival‑associated factors of first‑line EGFR‑tyrosine kinase inhibitor responders and non‑responders in lung adenocarcinoma patients with common EGFR mutations

Hung,Ming‑Szu; Fang,Yu‑Hung; Lin,Yu‑Ching; Lung,Jr‑Hau; Hsieh,Meng‑Jer; Tsai,Ying‑Huang

doi:10.3892/mco.2018.1550

Survival‑associated factors of first‑line EGFR‑tyrosine kinase inhibitor responders and non‑responders in lung adenocarcinoma patients with common EGFR mutations

Authors:
- Ming‑Szu Hung
- Yu‑Hung Fang
- Yu‑Ching Lin
- Jr‑Hau Lung
- Meng‑Jer Hsieh
- Ying‑Huang Tsai
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Affiliations: Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi 61363, Taiwan, R.O.C., Department of Medical Research and Development, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi 61363, Taiwan, R.O.C., Division of Pulmonary Infection and Critical Care, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi 61363, Taiwan, R.O.C.
Published online on: January 10, 2018 https://doi.org/10.3892/mco.2018.1550
Pages: 421-428
Copyright: © Hung et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present retrospective cohort study was to elucidate the clinical presentation of epidermal growth factor receptor (EGFR)‑tyrosine kinase inhibitor (TKI) responders and non‑responders in lung adenocarcinoma patients with common EGFR mutations. The cohort included 131 lung adenocarcinoma patients with common exon 19 or exon 21 EGFR mutations, who were receiving first‑line EGFR‑TKI therapy. The patient characteristics, treatment regimen and outcomes were recorded and analyzed. Of the 131 patients, 104 (79.3%) responded to treatment, while 27 (20.7%) did not. A significantly longer median progression‑free survival (PFS) [14.3, 95% confidence interval (CI): 12.2‑18.4 vs. 5.7, 95% CI: 2.7‑9.9 months; P<0.001] and overall survival (OS) (42.2, 95% CI: 28.1‑58.1 vs. 11.5, 95% CI: 8.3‑19.7 months; P<0.001) were observed in responders compared with non‑responders. In responders, bone [hazard ratio (HR)=1.87, 95% CI: 1.11‑3.20, P=0.021] and pleural (HR=2.40, 95% CI: 1.37‑4.22, P=0.002) metastasis were independent factors of PFS. Exon 19 mutations (HR=0.38, 95% CI: 0.19‑0.76, P=0.006), Eastern Cooperative Oncology Group performance status score ≥2 (HR=3.53, 95% CI: 1.42‑8.75, P=0.007) and bone metastasis (HR=2.01, 95% CI: 1.05‑3.85, P=0.034), were independent factors of OS. In non‑responders, smoking (HR=3.97, 95% CI: 1.13‑13.91, P=0.031) was an independent factor of PFS. Different survival‑associated factors were observed between EGFR‑TKI responders and non‑responders. The development of new treatment strategies should be advocated in EGFR‑TKI non‑responders.

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