Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Kitasato University School of Nursing, Sagamihara, Japan.
Oncology. 2018;95(2):109-115. doi: 10.1159/000488594. Epub 2018 Apr 26.
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKIs) therapy has been recognized as the standard treatment for patients with non-small cell lung cancer (NSCLC) harboring EGFR mutations. However, resistance to EGFR-TKIs has been observed in certain subpopulations of these patients. We aimed to evaluate the impact of smoking history on the efficacy of EGFR-TKIs.
The records of patients (n = 248) with NSCLC harboring activating EGFR mutations who were treated with gefitinib or erlotinib at our institution between March 2010 and June 2016 were retrospectively reviewed, and the treatment outcomes were evaluated.
The overall response rate and median progression-free survival (PFS) were 59.7% and 10.7 months, respectively. The overall response rate was significantly higher in the ex- and nonsmokers than in the current smokers (64.6 vs. 51.1%, p = 0.038). PFS also differed significantly between the current smokers and the ex- and nonsmokers (12.4 vs. 7.4 months, p = 0.016). Multivariate analysis identified smoking history as an independent predictor of PFS and overall survival.
The clinical data obtained in this study provide a valuable rationale for considering smoking history as a predictor of the efficacy of EGFR-TKI in NSCLC patients harboring activating EGFR mutations.
表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）治疗已被认为是携带 EGFR 突变的非小细胞肺癌（NSCLC）患者的标准治疗方法。然而，在这些患者的某些亚群中已经观察到对 EGFR-TKIs 的耐药性。我们旨在评估吸烟史对 EGFR-TKIs 疗效的影响。
回顾性分析了 2010 年 3 月至 2016 年 6 月期间在我院接受吉非替尼或厄洛替尼治疗的携带激活型 EGFR 突变的 NSCLC 患者（n=248）的病历，并评估了治疗结果。
总体缓解率和中位无进展生存期（PFS）分别为 59.7%和 10.7 个月。与当前吸烟者相比，既往吸烟者和从不吸烟者的总体缓解率明显更高（64.6%比 51.1%，p=0.038）。PFS 也在当前吸烟者和既往吸烟者和从不吸烟者之间存在显著差异（12.4 个月比 7.4 个月，p=0.016）。多变量分析确定吸烟史是 PFS 和总生存的独立预测因素。
本研究获得的临床数据为将吸烟史作为预测携带激活型 EGFR 突变的 NSCLC 患者 EGFR-TKI 疗效的指标提供了有价值的依据。
