Survival of Patients with Epidermal Growth Factor Receptor-Mutated Metastatic Non-Small Cell Lung Cancer Treated beyond the Second Line in the Tyrosine Kinase Inhibitor Era
Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345514/
Domenico Galetta, Academic Editor Keywords: EGFR-genes, drug therapy, lung cancer, metastasis, survival analysis, TKI In 2020, lung cancer was still the leading cancer worldwide in terms of mortality. NSCLC accounts for nearly 85% of these cancers [ 1]. In the era of conventional cytotoxic drugs, the prognosis for this cancer was grim [ 2].
Key Points
• Conclusion/Relevance: “The aim of our retrospective, longitudinal and analytic study was to analyze the survival of EGFR-mutated patients treated beyond the second line of treatment. We confirmed in a population of 31 patients which received at least three lines of treatment that the Progression Free Survival (PFS) was best if we used chemotherapy in second-line and tyrosine kinase inhibitors (TKI) in third-line.”
• In this French study, 31 of 107 EGFR-mutated patients who benefitted from TKI or CT as third-line treatment were assessed.
• The third-line treatment sequence that resulted in the longest PFS was TKI-CT-TKI (8.9 months). In patients who received CT as second-line treatment, the researchers found significant PFS and OS benefit when using TKI vs CT as third-line treatment.
• “In our study, for patients treated with TKI in the second line, we did not find a significant difference between TKI and CT in third-line in terms of PFS (p = ) and OS (p = 0.525). CT remains an effective treatment in EGFR-mutated NSCLCs and should be used optimally as long as the patient’s condition allows due to their complementary effect to that of TKIs,” the authors wrote.
• The authors noted that PFS related to third-line treatment did not differ depending on the type of EGFR mutations harbored.
• In addition to being low powered, retrospective, and monocentric, another limitation of the study was that the researchers were unable to uncover the rationale for each patient’s therapeutic algorithm.