First-generation epithelial growth factor receptor tyrosine kinase inhibitor in the first-line treatment of advanced non-small cell lung cancer: 166 cases analysis of progression-free survival / 中国实用内科杂志

ABSTRACT

OBJECTIVE: Explore the clinical benefit factors of progression-free survival(PFS) in sensitive epithelial growth factor receptor(EGFR) gene mutated advanced non-small cell lung cancer patients treated with first-generation of EGFR tyrosine kinase inhibitor(TKI).METHODS: The clinical data of 166 patients who received first-line treatment with first-generation EGFR-TKI were retrospectively collected in 2016-2017 from Xiangya Hospital, Central South University. The patients were divided into three groups PFS≤3 m,3 mRESULTS: The first generation of EGFR-TKI is independent factors affecting PFS, and the risk of progression of erlotinib was 2.16 times that of icotinib, and the risk of progression of gefitinib was 4.48 times that of icotinib.Logistic regression analysis of PFS≤3 m and PFS≥12 m showed that the efficacy of Icotinib was the best(Icotinib vs. Gefitinib, P=0.009; Icotinib vs. Erlotinib, P=0.006). PFS in the EGFR 19 del group was superior to that in the EGFR21 L858 R group(P=0.024). PFS in the adenocarcinoma group was superior to that in the non-adenocarcinoma group(P=0.044). PFS in moderate differentiation group was superior to that in the lower differentiation group(P=0.022). Multivariate analysis showed that the efficacy of the icotinib group was better than that of the erlotinib and gefitinib group(P=0.018; P=0.006), and the adenocarcinoma group was superior to non-adenocarcinoma(P=0.015), and the medium differentiated group was better than the poorly differentiated group(P=0.034).

CONCLUSION:

NSCLC patients with EGFR sensitive mutation may have different PFS at different baseline states such as histological type, differentiation degree, EGFR gene mutation type. First-generation EGFR-TKI may be an independent factor affecting PFS.