1. Primary Tumor Resection Is Associated with a Better Outcome among Advanced EGFR-Mutant Lung Adenocarcinoma Patients Receiving EGFR-TKI Treatment.
- Author
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Tseng, Jeng-Sen, Hsu, Kuo-Hsuan, Zheng, Zhe-Rong, Yang, Tsung-Ying, Chen, Kun-Chieh, Huang, Yen-Hsiang, Su, Kang-Yi, Yu, Sung-Liang, and Chang, Gee-Chen
- Subjects
THERAPEUTIC use of antineoplastic agents ,LUNG cancer prognosis ,ADENOCARCINOMA ,CANCER patients ,COMPARATIVE studies ,CONFIDENCE intervals ,LUNG cancer ,MEDICAL records ,GENETIC mutation ,SURVIVAL ,PROTEIN-tyrosine kinase inhibitors ,TREATMENT effectiveness ,RETROSPECTIVE studies ,EPIDERMAL growth factor receptors ,DESCRIPTIVE statistics ,ACQUISITION of data methodology - Abstract
Objectives: The characteristics and efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) in advanced EGFR-mutant lung adenocarcinoma patients with primary tumor resection (PTR) is not yet clear. Methods: We enrolled advanced EGFR-mutant lung adenocarcinoma patients with EGFR-TKI as first-line therapy to access the impact of PTR on the outcomes. Results: A total of 466 patients were enrolled with 76 patients (16.3%) undergoing PTR; 59 patients recurred after curative surgery, while 17 patients underwent surgery as diagnostic purposes. PTR patients displayed a better performance status, a lower metastatic burden, and much less measurable diseases (30.3 vs. 97.4%, p < 0.001). PTR patients experienced a significantly longer progression-free survival (25.1 [95% CI 16.6–33.7] vs. 9.4 [95% CI 8.4–10.4] months; aHR 0.40 [95% CI 0.30–0.54], p < 0.001) and overall survival (56.8 [95% CI 36.3–77.2] vs. 31.8 [95% CI 28.2–35.4] months; aHR 0.57 [95% CI 0.39–0.84], p = 0.004). Survival advantage was still observed while comparing PTR patients with the better performance and lower metastatic burden subgroup found within the non-resection group. Moreover, the progression-free survival and overall survival of 11 patients who were found having pleural metastases during surgery and underwent PTR plus pleural biopsy, were also longer than those with pure N0--1/M1a-malignant pleural effusion disease in the non-resection group (n = 19) (p < 0.001 and p = 0.002, respectively). Conclusion: PTR was associated with significantly better outcomes in advanced lung adenocarcinoma patients treated with EGFR-TKI. Further studies are needed to evaluate the biological role of PTR among these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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