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Tytuł:
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Comparing survival and subsequent treatment of first-line tyrosine kinase inhibitors in patients of advanced lung adenocarcinoma with epidermal growth factor receptor mutation.
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Autorzy:
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Huang MY; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Hsieh KP; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Huang RY; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan.
Hung JY; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Chen LT; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Tsai MJ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: .
Yang YH; School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan. Electronic address: .
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Źródło:
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Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2022 Jan; Vol. 121 (1 Pt 1), pp. 170-180. Date of Electronic Publication: 2021 Mar 09.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2003- : Singapore : Formosan Medical Association, Elsevier
Original Publication: Taipei, Taiwan : Formosan Medical Association, [1991-
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MeSH Terms:
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Adenocarcinoma of Lung*/drug therapy
Adenocarcinoma of Lung*/genetics
ErbB Receptors/genetics ; Humans ; Mutation ; Protein Kinase Inhibitors/therapeutic use ; Retrospective Studies
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Contributed Indexing:
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Keywords: Effectiveness; Erlotinib; Gefitinib; Targeted therapy; afatinib
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Substance Nomenclature:
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0 (Protein Kinase Inhibitors)
EC 2.7.10.1 (ErbB Receptors)
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Entry Date(s):
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Date Created: 20210312 Date Completed: 20211221 Latest Revision: 20211221
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Update Code:
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20240104
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DOI:
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10.1016/j.jfma.2021.02.012
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PMID:
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33707140
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Background/purpose: Three first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are widely available to treat advanced lung adenocarcinoma harboring EGFR mutation. However, studies comparing efficacy or effectiveness of these EGFR TKIs came out with inconclusive results.
Methods: In this real-world data analysis with a nationwide retrospective cohort design, adult patients with newly diagnosed advanced lung adenocarcinoma with EGFR mutation between 2011 and 2016, who received a first-line EGFR TKI, were included. Overall survival (OS) and time to next treatment (TTNT) were compared between patients receiving different EGFR TKIs after overlap weighting.
Results: We enrolled 10,431 patients, including 6,230, 2,359, and 1842 in gefitinib, erlotinib, and afatinib groups, respectively. The median (95% confidence interval [CI]) OS were 24.2 (22.9-26.2), 25.7 (24.0-27.9), and 29.1 (25.8-32.1) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p = 0.001). The hazard ratios (95% CI) for the afatinib group were 0.85 (0.74-0.98) and 0.91 (0.79-1.05) comparing with the gefitinib and erlotinib groups, respectively. The median (95% CI) TTNT were 10.9 (10.4-11.2), 11.7 (11.3-12.1), 13.4 (12.5-14.3) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p < 0.001). The hazard ratios (95% CI) for the afatinib group were 0.79 (0.70-0.88) and 0.89 (0.79-1.00) comparing with the gefitinib and erlotinib groups, respectively. There were 6111 (59%) patients receiving subsequent therapies, and the majority of them received a second-line chemotherapy, particularly platinum-based chemotherapy.
Conclusion: Afatinib, compared with gefitinib, might provide better effectiveness as the first-line targeted therapy for patients of advanced lung adenocarcinoma with EGFR mutation.
Competing Interests: Declaration of competing interest LTC received honorariums from Eli Lilly, TTY Biopharm, Sanofi, SynCore Biotechnology, Astellas Pharma, PharmaEngine, and Ipsen, and also received study medications from TTY Biopharm, Syncore Biotechnology, and Celgene for other investigator-initiated trials. JYH received honorariums from Eli Lilly, Sanofi, Roche, AstraZeneca, Boehringer Ingelheim, Ono, and MSD. MJT received honorariums for lectures, which were not associated with this article, from AstraZeneca and Boehringer Ingelheim. The other authors have declared no conflicts of interest related to this article.
(Copyright © 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)
