Survival benefit of first-generation epidermal growth factor receptor-tyrosine kinase inhibitors in female with advanced lung cancer

Tumori. 2019 Jun;105(3):216-224. doi: 10.1177/0300891619839292. Epub 2019 Mar 25.

Abstract

Background: This study aimed to estimate therapeutic effects of first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in real-world practice, by analyzing survival outcomes in an unselected, Korean female population with advanced lung cancer based on the National Health Insurance Service database.

Methods: We identified women with newly diagnosed advanced lung cancer from January 2004 to December 2013. For progression-free survival (PFS) and overall survival (OS) analyses, patients were defined into the following subgroups: group A, treated with first-generation EGFR-TKI ⩾6 months; group B, treated with EGFR-TKIs <6 months but at least >1 month; and group C, treated with cytotoxic chemotherapy as follows: monotherapy or combination therapy with gemcitabine or pemetrexed; or monotherapy with docetaxel, paclitaxel, or vinorelbine.

Results: Among 11,045 enrolled patients, 6170 (55.8%) were treated with first-generation EGFR-TKIs for at least 1 month. The median OS for patients treated with EGFR-TKIs was significantly longer than that of EGFR-TKI-naive patients (19.1 months [95% confidence interval (CI) 18.5-19.7] vs 9.5 months [95% CI 9.1-9.8], P<0.001). In subgroup analysis, group A had a significantly longer median OS compared with group B (30.3 months [95% CI 29.5-31.2] vs 12.3 months [95% CI 11.9-12.7], P<0.001). The median PFS of group A was significantly longer than that of group B (15.8 vs 3.7 months, P<0.001).

Conclusions: Our analysis demonstrates that EGFR-TKIs confer significant PFS and OS benefits in the real-world practice for Korean female with advanced lung cancer.

Keywords: Advanced lung cancer; EGFR-TKI; Korea; big data; female.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Carcinoma, Non-Small-Cell Lung
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Middle Aged
  • Mutation
  • Neoplasm Staging
  • Pemetrexed / administration & dosage
  • Progression-Free Survival
  • Protein Kinase Inhibitors / administration & dosage*

Substances

  • Protein Kinase Inhibitors
  • Pemetrexed
  • Deoxycytidine
  • gemcitabine
  • EGFR protein, human
  • ErbB Receptors