Epidermal Growth Factor Receptor (EGFR)-tyrosine Kinase Inhibitors As a First-line Treatment for Postoperative Recurrent and EGFR-mutated Non-small-cell Lung Cancer

Overview

Journal Interact Cardiovasc Thorac Surg

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2021 Oct 15

PMID 34652430

Citations 6

Authors

Tetsuji Moriya

Masatsugu Hamaji

Akihiko Yoshizawa

Ryo Miyata

Misa Noguchi

Shigeyuki Tamari

Naohisa Chiba

Hideaki Miyamoto

Toshiya Toyazaki

Satona Tanaka

Yoshito Yamada

Yojiro Yutaka

Daisuke Nakajima

Akihiro Ohsumi

Toshi Menju

Hiroshi Date

Affiliations

Soon will be listed here.

Abstract

Objectives: To clarify survival outcomes and prognostic factors of patients receiving epidermal growth factor receptor (EGFR) - tyrosine kinase inhibitors (TKIs) as first-line treatment for postoperative recurrence.

Methods: A retrospective chart review was performed to identify consecutive patients who received EGFR-TKIs as first-line treatment for postoperative recurrence of non-small-cell lung cancer (NSCLC) harbouring EGFR gene mutations at our institution between August 2002 and October 2020. Therapeutic response, adverse events, progression-free survival (PFS) and overall survival (OS) were investigated. Survival outcomes were assessed using the Kaplan-Meier analysis. The Cox proportional hazards model was used for univariable and multivariable analyses.

Results: Sixty-four patients were included in the study. The objective response and disease control rates were 53% and 92%, respectively. Grade 3 or greater adverse events were noted in 4 (6.3%) patients, including 1 patient (1.6%) of interstitial pneumonia. The median follow-up period was 28.5 months (range 3-202 months). The total number of events was 43 for PFS and 23 for OS, respectively. The median PFS was 18 months, and the median OS was 61 months after EGFR-TKI treatment. In multivariable analysis, osimertinib showed a tendency to prolong PFS [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.12-1.1; P = 0.071], whereas the micropapillary component was significantly associated with shorter OS (HR 2.1, 95% CI 1.02-6.9; P = 0.045).

Conclusions: EGFR-TKIs as first-line treatment appeared to be a reasonable treatment option in selected patients with postoperative recurrent EGFR-mutated NSCLC. Osimertinib and the micropapillary component may be prognostic factors.

Citing Articles

Pathological Features and Differential Efficacy of Cisplatin-Based Adjuvant Chemotherapy in Lung Cancer Harboring Epidermal Growth Factor Receptor Mutations.

Kabuto T, Menju T, Nishikawa S, Terada K, Yoshizawa A, Date H Ann Thorac Cardiovasc Surg. 2025; 31(1).

PMID: 39842815 PMC: 11769713. DOI: 10.5761/atcs.oa.24-00149.

Editorial: Mechanisms of drug resistance to targeted therapy in malignancies.

Hamaji M Front Oncol. 2024; 14:1363808.

PMID: 38313799 PMC: 10836402. DOI: 10.3389/fonc.2024.1363808.

Optimal Treatment Strategy for Oligo-Recurrence Lung Cancer Patients with Driver Mutations.

Tachibana T, Matsuura Y, Ninomiya H, Ichinose J, Nakao M, Okumura S Cancers (Basel). 2024; 16(2).

PMID: 38275904 PMC: 10814831. DOI: 10.3390/cancers16020464.

Outcomes of immune checkpoint inhibitors for postoperative recurrence of non-small cell lung cancer.

Yuasa I, Hamaji M, Ozasa H, Sakamori Y, Yoshida H, Yutaka Y Gen Thorac Cardiovasc Surg. 2023; 71(9):534-541.

PMID: 36811789 DOI: 10.1007/s11748-023-01920-z.

Examination of the effectiveness of local therapy for oligo-recurrence of EGFR-mutated NSCLC.

Sonoda D, Kondo Y, Maruyama R, Hayashi S, Naito M, Mikubo M Thorac Cancer. 2023; 14(8):766-772.

PMID: 36720507 PMC: 10008676. DOI: 10.1111/1759-7714.14805.

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