Epidermal growth factor receptor tyrosine kinase inhibitors for non-small cell lung cancer harboring uncommon EGFR mutations: Real-world data from Taiwan

被引:13
作者
Chang, John Wen-Cheng [1 ]
Huang, Chen-Yang [1 ]
Fang, Yueh-Fu [2 ]
Chang, Ching-Fu [2 ]
Yang, Cheng-Ta [2 ]
Kuo, Chih-Hsi Scott [2 ]
Hsu, Ping-Chih
Wu, Chiao-En [1 ,3 ]
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp Linkou, Coll Med, Dept Internal Med,Div Hematol Oncol, Taoyuan, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp Linkou, Dept Thorac Med, Div Thorac Oncol,Coll Med, Taoyuan, Taiwan
[3] Chang Gung Univ, Chang Gung Mem Hosp Linkou, Dept Internal Med, Div Haematol Oncol,Coll Med, 5 Fu Hsing St, Taoyuan, Taiwan
关键词
afatinib; erlotinib; gefitinib; lung cancer; uncommon mutation; 1ST-LINE TREATMENT; OPEN-LABEL; GEFITINIB; AFATINIB; CHEMOTHERAPY; ADENOCARCINOMA; MULTICENTER; ERLOTINIB;
D O I
10.1111/1759-7714.14537
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundEpidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard treatment for patients with non-small cell lung cancer (NSCLC) harboring EGFR mutations. This study aimed to evaluate the efficacy of EGFR-TKIs and prognostic factors for patients with NSCLC harboring uncommon EGFR mutations, which account for 10% of EGFR mutations. MethodsA total of 230 treatment-naive patients with NSCLC harboring uncommon EGFR mutations treated with first-line EGFR-TKIs between 2011 and 2018 at four hospitals (belonging to four institutions, Linkou, Kaohsiung, Keelung, and Chiayi, of the Chang Gung Memorial Hospital) in Taiwan were retrospectively reviewed. Their clinicopathological characteristics, adverse events (AEs), objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) were collected. Univariate and multivariate analyses were performed to identify potential prognostic factors for PFS. ResultsOverall, patients who received afatinib (n = 62) had better PFS (median: 6.4 vs. 5.9 months, p = 0.022) and OS (median: 13.4 vs. 13.0 months, p = 0.008) than those who received gefitinib/erlotinib (n = 124), although no significant differences were observed for ORR (46.8% vs. 35.5%, p = 0.137) or DCR (59.7% vs. 58.9%, p = 0.916). Patients who received afatinib showed significantly higher ORR (58.3% vs. 31.3%, p = 0.027) but not DCR compared with gefitinib/erlotinib for major uncommon mutations. Afatinib trended toward better PFS and OS for major uncommon mutations and compound mutations. No EGFR-TKIs were effective for most NSCLC patients with exon 20 insertions. Performance status, metastasis of the liver and pleura, and dose reduction were independent prognostic factors for PFS. ConclusionAfatinib demonstrated better survival outcomes than gefitinib/erlotinib for NSCLC patients harboring major EGFR uncommon mutations and compound mutations. Performance status and metastatic sites may be useful for predicting PFS for major uncommon mutations and compound mutations.
引用
收藏
页码:12 / 23
页数:12
相关论文
共 28 条
[1]   Risk Stratification Using a Novel Nomogram for 2190 EGFR-Mutant NSCLC Patients Receiving the First or Second Generation EGFR-TKI [J].
Chang, John Wen-Cheng ;
Huang, Chen-Yang ;
Fang, Yueh-Fu ;
Chang, Ching-Fu ;
Yang, Cheng-Ta ;
Kuo, Chih-Hsi Scott ;
Hsu, Ping-Chih ;
Wu, Chiao-En .
CANCERS, 2022, 14 (04)
[2]   Non-small cell lung cancer harbouring non-resistant uncommon EGFR mutations: Mutation patterns, effectiveness of epidermal growth factor receptor-tyrosine kinase inhibitors and prognostic factors [J].
Chang, Lih-Chyun ;
Lim, Chor-Kuan ;
Chang, Lih-Yu ;
Chen, Kuan-Yu ;
Shih, Jin-Yuan ;
Yu, Chong-Jen .
EUROPEAN JOURNAL OF CANCER, 2019, 119 :77-86
[3]   Cutaneous adverse events of epidermal growth factor receptor inhibitors: A retrospective review of 99 cases [J].
Chanprapaph, Kumutnart ;
Pongcharoen, Padcha ;
Vachiramon, Vasanop .
INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY & LEPROLOGY, 2015, 81 (05) :547
[4]   Real-world Afatinib Outcomes in Advanced Non-small Cell Lung Cancer Harboring EGFR Mutations [J].
Chen, Chi-Han ;
Chang, John Wen-Cheng ;
Chang, Ching-Fu ;
Huang, Chen-Yang ;
Yang, Cheng-Ta ;
Kuo, Chih-Hsi Scott ;
Fang, Yueh-Fu ;
Hsu, Ping-Chih ;
Wu, Chiao-En .
ANTICANCER RESEARCH, 2022, 42 (04) :2145-2157
[5]   Mobocertinib (TAK-788): A Targeted Inhibitor of EGFR Exon 20 Insertion Mutants in Non-Small Cell Lung Cancer [J].
Gonzalvez, Francois ;
Vincent, Sylvie ;
Baker, Theresa E. ;
Gould, Alexandra E. ;
Li, Shuai ;
Wardwell, Scott D. ;
Nadworny, Sara ;
Ning, Yaoyu ;
Zhang, Sen ;
Huang, Wei-Sheng ;
Hu, Yongbo ;
Li, Feng ;
Greenfield, Matthew T. ;
Zech, Stephan G. ;
Das, Biplab ;
Narasimhan, Narayana, I ;
Clackson, Tim ;
Dalgarno, David ;
Shakespeare, William C. ;
Fitzgerald, Michael ;
Chouitar, Johara ;
Griffin, Robert J. ;
Liu, Shengwu ;
Wong, Kwok-Kin ;
Zhu, Xiaotian ;
Rivera, Victor M. .
CANCER DISCOVERY, 2021, 11 (07) :1672-1687
[6]   Survival-associated factors of first-line EGFR-tyrosine kinase inhibitor responders and non-responders in lung adenocarcinoma patients with common EGFR mutations [J].
Hung, Ming-Szu ;
Fang, Yu-Hung ;
Lin, Yu-Ching ;
Lung, Jr-Hau ;
Hsieh, Meng-Jer ;
Tsai, Ying-Huang .
MOLECULAR AND CLINICAL ONCOLOGY, 2018, 8 (03) :421-428
[7]   Treatment and Outcomes of Metastatic Non-Small-Cell Lung Cancer Harboring Uncommon EGFR Mutations: Are They Different from Those with Common EGFR Mutations? [J].
Jung, Hyun Ae ;
Park, Sehhoon ;
Sun, Jong-Mu ;
Lee, Se-Hoon ;
Ahn, Jin Seok ;
Ahn, Myung-Ju ;
Park, Keunchil .
BIOLOGY-BASEL, 2020, 9 (10) :1-10
[8]   Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis [J].
Kate, Shruti ;
Chougule, Anuradha ;
Joshi, Amit ;
Noronha, Vanita ;
Patil, Vijay ;
Dusane, Rohit ;
Solanki, Leena ;
Tiwrekar, Priyanka ;
Trivedi, Vaishakhi ;
Prabhash, Kumar .
LUNG CANCER-TARGETS AND THERAPY, 2019, 10 :1-10
[9]   Skin Rash could Predict the Response to EGFR Tyrosine Kinase Inhibitor and the Prognosis for Patients with Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis [J].
Liu, Hong-bing ;
Wu, Ying ;
Lv, Tang-feng ;
Yao, Yan-wen ;
Xiao, Yong-ying ;
Yuan, Dong-mei ;
Song, Yong .
PLOS ONE, 2013, 8 (01)
[10]   Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib [J].
Lynch, TJ ;
Bell, DW ;
Sordella, R ;
Gurubhagavatula, S ;
Okimoto, RA ;
Brannigan, BW ;
Harris, PL ;
Haserlat, SM ;
Supko, JG ;
Haluska, FG ;
Louis, DN ;
Christiani, DC ;
Settleman, J ;
Haber, DA .
NEW ENGLAND JOURNAL OF MEDICINE, 2004, 350 (21) :2129-2139