Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation

Miaomiao Wen,1 Jinghua Xia,1 Ying Sun,1 Xuejiao Wang,1 Xianghui Fu,2 Yanning Zhang,1 Zhipei Zhang,1 Yongan Zhou,1 Xiaofei Li1 1Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an 710038, Shaanxi, China; 2Department of Clinical Immunology, Xijing H...

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Autores principales:	Wen M, Xia J, Sun Y, Wang X, Fu X, Zhang Y, Zhang Z, Zhou Y, Li X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	non-small cell lung cancer epidermal growth factor receptor-tyrosine kinase inhibitor chemotherapy adjuvant therapy retrospective study Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/5721e734a9a4434fac18327b628d2716
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spelling	oai:doaj.org-article:5721e734a9a4434fac18327b628d27162021-12-02T00:20:20ZCombination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation1177-5491https://doaj.org/article/5721e734a9a4434fac18327b628d27162018-11-01T00:00:00Zhttps://www.dovepress.com/combination-of-egfr-tkis-with-chemotherapy-versus-chemotherapy-or-egfr-peer-reviewed-article-BTThttps://doaj.org/toc/1177-5491Miaomiao Wen,1 Jinghua Xia,1 Ying Sun,1 Xuejiao Wang,1 Xianghui Fu,2 Yanning Zhang,1 Zhipei Zhang,1 Yongan Zhou,1 Xiaofei Li1 1Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an 710038, Shaanxi, China; 2Department of Clinical Immunology, Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, Shaanxi, China Purpose: Both epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and chemotherapy are widely applied for the treatment of advanced non-small-cell lung cancer (NSCLC) with EGFR mutations, and the combination of EGFR-TKIs and chemotherapy has been used for advanced NSCLC patients; however, little is known about the efficacy of the direct comparison among them.Patients and methods: The demographic and clinical characteristics of 92 patients harboring advanced NSCLC with EGFR mutation were retrospectively reviewed. We evaluated the effects of EGFR-TKIs, chemotherapy, and EGFR-TKIs plus chemotherapy on advanced NSCLC patients with EGFR mutations, and the efficacy of combination of chemotherapy and EGFR-TKIs vs chemotherapy or EGFR-TKIs alone in advanced NSCLC patients was evaluated.Results: The statistical results showed that the intercalated combination of EGFR-TKIs plus chemotherapy significantly improved progression-free survival (PFS; HR, 1.76; 95% CI 1.03–3.01; P=0.036; median, 20.5 vs 16 months) compared with EGFR-TKI monotherapy, but no difference in overall survival (OS) was observed between these two groups (HR, 1.52; 95% CI 0.81–2.83; P=0.19; median, 36 vs 29 months). However, patients who received the combination of chemotherapy and EGFR-TKIs had longer PFS (HR, 2.78; 95% CI 1.57–4.93; P<0.0001; median, 20.5 vs 12 months) as well as OS (HR, 2.86; 95% CI 1.56–5.27; P=0.001; median, 36 vs 18 months) than those who received chemotherapy alone. Toxicities were mild among the three treatment groups. Rash and diarrhea were common adverse events (AEs) in the EGFR-TKI group, anemia and nausea in the chemotherapy group, and anemia and diarrhea in the combination group.Conclusion: This study demonstrated that the combination of chemotherapy with EGFR-TKIs as first-line treatment has a significant effect on PFS in patients with advanced NSCLC whose tumors harbor activating EGFR mutations. The combination treatment had more toxicity, but was clinically manageable. Keywords: non-small-cell lung cancer, epidermal growth factor receptor-tyrosine kinase inhibitor, chemotherapy, adjuvant therapy, retrospective studyWen MXia JSun YWang XFu XZhang YZhang ZZhou YLi XDove Medical Pressarticlenon-small cell lung cancerepidermal growth factor receptor-tyrosine kinase inhibitorchemotherapyadjuvant therapyretrospective studyMedicine (General)R5-920ENBiologics: Targets & Therapy, Vol Volume 12, Pp 183-190 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	non-small cell lung cancer epidermal growth factor receptor-tyrosine kinase inhibitor chemotherapy adjuvant therapy retrospective study Medicine (General) R5-920
spellingShingle	non-small cell lung cancer epidermal growth factor receptor-tyrosine kinase inhibitor chemotherapy adjuvant therapy retrospective study Medicine (General) R5-920 Wen M Xia J Sun Y Wang X Fu X Zhang Y Zhang Z Zhou Y Li X Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
description	Miaomiao Wen,1 Jinghua Xia,1 Ying Sun,1 Xuejiao Wang,1 Xianghui Fu,2 Yanning Zhang,1 Zhipei Zhang,1 Yongan Zhou,1 Xiaofei Li1 1Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, Xi’an 710038, Shaanxi, China; 2Department of Clinical Immunology, Xijing Hospital, The Fourth Military Medical University, Xi’an 710032, Shaanxi, China Purpose: Both epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and chemotherapy are widely applied for the treatment of advanced non-small-cell lung cancer (NSCLC) with EGFR mutations, and the combination of EGFR-TKIs and chemotherapy has been used for advanced NSCLC patients; however, little is known about the efficacy of the direct comparison among them.Patients and methods: The demographic and clinical characteristics of 92 patients harboring advanced NSCLC with EGFR mutation were retrospectively reviewed. We evaluated the effects of EGFR-TKIs, chemotherapy, and EGFR-TKIs plus chemotherapy on advanced NSCLC patients with EGFR mutations, and the efficacy of combination of chemotherapy and EGFR-TKIs vs chemotherapy or EGFR-TKIs alone in advanced NSCLC patients was evaluated.Results: The statistical results showed that the intercalated combination of EGFR-TKIs plus chemotherapy significantly improved progression-free survival (PFS; HR, 1.76; 95% CI 1.03–3.01; P=0.036; median, 20.5 vs 16 months) compared with EGFR-TKI monotherapy, but no difference in overall survival (OS) was observed between these two groups (HR, 1.52; 95% CI 0.81–2.83; P=0.19; median, 36 vs 29 months). However, patients who received the combination of chemotherapy and EGFR-TKIs had longer PFS (HR, 2.78; 95% CI 1.57–4.93; P<0.0001; median, 20.5 vs 12 months) as well as OS (HR, 2.86; 95% CI 1.56–5.27; P=0.001; median, 36 vs 18 months) than those who received chemotherapy alone. Toxicities were mild among the three treatment groups. Rash and diarrhea were common adverse events (AEs) in the EGFR-TKI group, anemia and nausea in the chemotherapy group, and anemia and diarrhea in the combination group.Conclusion: This study demonstrated that the combination of chemotherapy with EGFR-TKIs as first-line treatment has a significant effect on PFS in patients with advanced NSCLC whose tumors harbor activating EGFR mutations. The combination treatment had more toxicity, but was clinically manageable. Keywords: non-small-cell lung cancer, epidermal growth factor receptor-tyrosine kinase inhibitor, chemotherapy, adjuvant therapy, retrospective study
format	article
author	Wen M Xia J Sun Y Wang X Fu X Zhang Y Zhang Z Zhou Y Li X
author_facet	Wen M Xia J Sun Y Wang X Fu X Zhang Y Zhang Z Zhou Y Li X
author_sort	Wen M
title	Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
title_short	Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
title_full	Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
title_fullStr	Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
title_full_unstemmed	Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation
title_sort	combination of egfr-tkis with chemotherapy versus chemotherapy or egfr-tkis alone in advanced nsclc patients with egfr mutation
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/5721e734a9a4434fac18327b628d2716
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Combination of EGFR-TKIs with chemotherapy versus chemotherapy or EGFR-TKIs alone in advanced NSCLC patients with EGFR mutation

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