Background Traditional chemotherapy regimens used in the treatment of non-small cell lung cancer (NSCLC) have limited efficacy with considerable toxicity.
Purpose To analyse the effectiveness of tyrosine kinase inhibitors (TKIs) according to epidermal growth factor receptor (EGFR) mutational status.
Materials and methods Retrospective observational study conducted in 2013. We included all patients with NSCLC treated with TKIs. Variables collected were: demographics (age, sex), clinical status (EGFR mutational status), pharmacology (drug), effectiveness (progression-free survival (PFS) and overall survival (OS)). Information sources used were prescribing and medical history electronic records.
Results We included 48 patients with an average age of 62 (60% male, 40% female). 79%, 17% and 4% of patients received erlotinib, gefitinib and afatinib respectively. EGFR-activating mutations were found in 23% of patients, not found in 31% and were unknown in 46% remaining patients. Median PFS (mPFS) were 2.39, 5.42 and 4.52 months with erlotinib, gefitinib and afatinib respectively. Median OS (mOS) were 2.74, 9.73 and 7.3 months with erlotinib, gefitinib and afatinib treatment respectively. The mOS and mPFS in patients with wild-type EGFR, treated with erlotinib, were 3.17 and 1.21 months respectively versus 12.97 and 7.33 months achieved in patients who had these mutations. In patients with mutated-EGFR the mOS and mPFS were 13.87 and 9.73 months in gefitinib treatment and 7.33 and 7.3 months in afatinib treatment respectively.
Conclusions Median OS and PFS achieved in mutated-EGFR patients treated with erlotinib are lower than those reached in the EURTAC clinical trial (19.3 and 10.4 respectively). Regarding gefitinib, mPFS were similar to those reached in the IPASS and ISEL CTs (9.5 and 10.8 months respectively), whereas mOS were lower (13.8 vs. 21.6 months). These discrepancies are probably due to differences in clinical characteristics of patients. The results obtained with afatinib were not comparable with CTs because in our patients it was not used in first-line. These differences should be confirmed with further studies.
No conflict of interest.
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