Comparing the effectiveness of different EGFR-TKIs in patients with EGFR mutant non-small-cell lung cancer: A retrospective cohort study in Taiwan.
Adult
Afatinib
/ therapeutic use
Aged
Carcinoma, Non-Small-Cell Lung
/ drug therapy
ErbB Receptors
/ antagonists & inhibitors
Erlotinib Hydrochloride
/ therapeutic use
Female
Gefitinib
/ therapeutic use
Humans
Lung Neoplasms
/ drug therapy
Male
Middle Aged
Mutation
Protein Kinase Inhibitors
/ therapeutic use
Retrospective Studies
Survival Analysis
Taiwan
Treatment Outcome
Young Adult
epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs)
non-small-cell lung cancer (NSCLC)
overall survival
real-world data
treatment effectiveness
Journal
International journal of cancer
ISSN: 1097-0215
Titre abrégé: Int J Cancer
Pays: United States
ID NLM: 0042124
Informations de publication
Date de publication:
15 08 2020
15 08 2020
Historique:
received:
23
08
2019
revised:
29
11
2019
accepted:
02
12
2019
pubmed:
20
12
2019
medline:
7
4
2021
entrez:
20
12
2019
Statut:
ppublish
Résumé
The study was to compare the effectiveness of different epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced non-small-cell lung cancer (NSCLC) and received EGFR-TKIs as first-line therapy. This retrospective cohort study was conducted using data from real-world settings. Patients with stage IIIB and IV NSCLC and first received gefitinib, erlotinib, or afatinib between 2011 and 2015 were included. The date of the first claim for EGFR-TKIs was set as the index date. Study endpoints were all-cause death and treatment failure that was defined when patients added on or switched to chemotherapy or terminal care. A total of 5,940 patients, including 3,982 (67.0%) receiving gefitinib, 1,207 (20.3%) receiving erlotinib, and 751 (12.7%) receiving afatinib, were eligible for this study. The 1-year overall survival (OS) rates for gefitinib, erlotinib, and afatinib groups were 74% (95% confidence interval [CI]: 72-75%), 75% (95% CI: 73-77%), and 80% (95% CI: 77-83%), respectively. Compared to gefitinib, afatinib was associated with a lower risk of all-cause death (adjusted hazard ratio [aHR] = 0.82, 95% CI: 0.72-0.93) but not erlotinib (aHR = 0.95, 95% CI: 0.86-1.05). Similar results were also found regarding the effectiveness of treatment. All the three EGFR-TKIs showed no differences for both outcomes among patients with an Eastern Cooperative Oncology Group Performance Score of 2. The real-world data exhibited afatinib was more likely to be used for younger patients in a better condition than other EGFR inhibitors, and observed prolonged OS and treatment effectiveness compared to gefitinib after performing a multivariate Cox regression analysis.
Substances chimiques
Protein Kinase Inhibitors
0
Afatinib
41UD74L59M
Erlotinib Hydrochloride
DA87705X9K
EGFR protein, human
EC 2.7.10.1
ErbB Receptors
EC 2.7.10.1
Gefitinib
S65743JHBS
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1107-1116Informations de copyright
© 2019 UICC.
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