Continued EGFR-TKIs treatment promotes the survival of elderly patients with acquired resistance to EGFR-TKIs therapy

OBJECTIVE: Continued EGFR-TKIs treatment is still controversial for NSCLC patients with activating EGFR mutations, who acquire resistance to the drug. Of these patients, elderly ones were worth to be investigated to further examine efficacy of continued EGFR-TKIs treatment. PATIENTS AND METHODS: A total of 232 NSCLC patients (70-year-old) were recruited from the Chinese People's Liberation Army General Hospital between January 1, 2009, and July 31, 2014. And 44 patients were qualified for further retrospectively investigated, which were divided into dramatic and non-dramatic progression groups based on the characteristics of progression during first-line EGFR-TKIs treatment. And they were also divided into two groups: continued EGFR-TKIs group and discontinued EGFR-TKIs group. Subsequently, progression-free survival (PFS), post-progression survival (PPS), and overall survival (OS) of these groups were investigated by multivariate analysis. RESULTS: Median OS (28.9 months vs. 23.2 months, p = 0.46) and median PPS (16.9 months vs. 4.4 months, p = 0.216) were both not significantly different between continued EGFR-TKIs groups and discontinued ones. However, when focusing on patients with non-dramatic progression, the median OS (29.0 months vs. 23.2 months, p = 0.039) and median PPS (21.3 months vs. 3.9 months, p = 0.001) were significantly longer in the continued EGFR-TKIs patients than discontinued ones. DISCUSSION: Continued EGFR-TKIs beyond PD may be a good option for elderly patients with non-dramatic progression. The characteristic of progression after first-line EGFR-TKIs treatment should be taken into account to determine which part of patients is suitable for continued EGFR-TKIs treatment, especially for the speed of progression. CONCLUSION: Continued EGFR-TKIs treatment promotes the survival of elderly patients with acquired resistance to EGFR-TKIs therapy.