Wu Chiao-En, Chang Ching-Fu, Huang Chen-Yang, Yang Cheng-Ta, Kuo Chih-Hsi Scott, Hsu Ping-Chih, Chang John Wen-Cheng
Division of Hematology-Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
Division of Thoracic Oncology, Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan.
Cancers (Basel). 2022 Jan 28;14(3):674. doi: 10.3390/cancers14030674.
The aim of this retrospective study was to investigate the tolerability and survival outcomes of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) treatment in patients with a performance status ≥ 2. The data for 517 patients treated with EGFR-TKIs between January 2011 and January 2018 at a regional hospital in northern Taiwan were analyzed. Clinical and pathological features were collected, and univariate as well as multivariable analyses were undertaken to identify potential prognostic factors. The overall objective response rate, median progression-free survival (PFS), and median overall survival (OS) were 56.3%, 11.4 months, and 15.3 months, respectively. The mutation status (exon 19 deletion), locally advanced disease, dose adjustment, and the lack of liver and pleural metastasis were independent and favorable prognostic factors for PFS. Age < 60 years, mutation status (exon 19 deletion), dose adjustment, and lack of lung, liver, and no pleural metastasis were independent and favorable prognostic factors for OS. GFR-TKIs demonstrated acceptable efficacy and safety in the current cohort. Dose adjustment was identified as an independent prognostic factor for both PFS and OS, regardless of which EGFR-TKIs were used. The current research provided novel evidence of the clinical prescription of frontline EGFR-TKIs for EGFR-mutated lung adenocarcinoma patients with a PS score ≥2.
本回顾性研究的目的是调查体能状态≥2的患者接受表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)治疗的耐受性和生存结果。分析了2011年1月至2018年1月间在台湾北部一家地区医院接受EGFR-TKIs治疗的517例患者的数据。收集了临床和病理特征,并进行单变量和多变量分析以确定潜在的预后因素。总体客观缓解率、中位无进展生存期(PFS)和中位总生存期(OS)分别为56.3%、11.4个月和15.3个月。突变状态(第19外显子缺失)、局部晚期疾病、剂量调整以及无肝和胸膜转移是PFS的独立且有利的预后因素。年龄<60岁、突变状态(第19外显子缺失)、剂量调整以及无肺、肝和胸膜转移是OS的独立且有利的预后因素。在当前队列中,EGFR-TKIs显示出可接受的疗效和安全性。无论使用哪种EGFR-TKIs,剂量调整均被确定为PFS和OS的独立预后因素。本研究为PS评分≥2的EGFR突变肺腺癌患者一线EGFR-TKIs的临床处方提供了新的证据。