ABSTRACT
BACKGROUND@#EGFR-tyrosine kinase inhibitors (EGFR-TKIs) were used to treat non-small cell lung cancer (NSCLC) patients with EGFR mutation positive. This study aims to compare the effectiveness of first line TKIs; gefitinib, erlotinib, and afatinib in the treatment of advanced stage NSCLC patients with EGFR mutation positive in the Indonesian population.@*METHODS@#A retrospective cohort study of 88 NSCLC patients with EGFR mutation positive treated with gefitinib (n=59), erlotinib (n=22), and afatinib (n=7) was performed in national cancer hospital in Indonesia.Inclusion criteria were stage IIIb or IV NSCLC with adenocarcinoma subtype. Subjects less than 18 years or with a history of other malignancy were excluded. Outcomes were treatment response, progression-free survival (PFS), and mortality rate.@*RESULTS@#Complete response, partial response, and stable disease were shown in 1.1%, 35.2%, and 31.8% of subjects, respectively. There were 31.8% of subjects developed progressive disease during treatment. Regarding EGFR mutation positive profile, a total of 56.8% subjects had deletion in exon 19, 42% subjects had mutation in exon 21, and rare mutation in exon 18 was found in 3.4% of total subjects. Demography and clinical characteristics had no significant association with the risk of progressive disease. The median PFS of subjects was 11 months (95%CI: 6.8-15.2 months). There was no statistical difference of PFS between treatment groups. CONCLUSIONS: Gefitinib, erlotinib, and afatinib have similar effectiveness in advanced stage NSCLC with EGFR mutation positive. Afatinib tends to be associated with longer PFS but further investigation is required.
ABSTRACT
@#Introduction: Overweight and obesity are considered risk factors for several solid and blood cancers. However, body mass index (BMI) is rarely assessed in newly diagnosed patients with cancer. This study aimed to evaluate BMI and its associated factors in patients with cancer. Methods: This cross-sectional study enrolled newly diagnosed cancer patients over the period January 2015–December 2017 at the Dharmais National Cancer Hospital, Jakarta. Demographic and clinical data were retrieved from the medical records. BMI was calculated for each patient. Comorbidity was evaluated using the Charlson Comorbidity Index. Results: In total, 696 newly diagnosed cancer patients were enrolled, with women in predominance (66.2%). The mean patient age was 54.0±12.8 years. Most patients (90.7%) had solid tumours; breast and lung cancers were the most common diagnosis. Among haematological malignancies, lymphoma was the most common (55.4%). Overweight or obesity, noted in 309 (44.4%) patients, was significantly associated with age, sex (women) and haematological malignancies. No association between disease stage and BMI was observed. Among patients with solid tumours, age and sex (women) was associated with overweight and obesity. Conclusion: The prevalence of overweight and obesity in newly diagnosed cancer patients was 44.4%. The proportion of this association was more prominent in women and in those with haematological malignancies. Among solid tumours, age and the female sex demonstrated the strongest association with overweight and obesity. Additional studies to assess whether certain dietary patterns and physical activity levels are risk factors for cancer are warranted.