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- Title
Best Response According to RECIST During First-line EGFR-TKI Treatment Predicts Survival in EGFR Mutation-positive Non-Small-cell Lung Cancer Patients.
- Authors
Ting-Hui Wu; Emily Han-Chung Hsiue; Jih-Hsiang Lee; Chia-Chi Lin; Wei-Yu Liao; Chao-Chi Ho; Jin-Yuan Shih; Chong-Jen Yu; James Chih-Hsin Yang; Wu, Ting-Hui; Hsiue, Emily Han-Chung; Lee, Jih-Hsiang; Lin, Chia-Chi; Liao, Wei-Yu; Ho, Chao-Chi; Shih, Jin-Yuan; Yu, Chong-Jen; Yang, James Chih-Hsin
- Abstract
<bold>Introduction: </bold>The association between the response to first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) and survival in EGFR mutation-positive non-small-cell lung cancer (NSCLC) remains unclear. We studied the association between the response to first-line EGFR-TKIs and survival using Response Evaluation Criteria In Solid Tumors (RECIST) and maximal tumor shrinkage.<bold>Materials and Methods: </bold>We analyzed data from patients with advanced EGFR mutation-positive NSCLC enrolled in first-line gefitinib and afatinib trials. A total of 98 patients who achieved a response or stable disease and had ≥ 1 measurable target lesion were included. The association between the best response by RECIST or maximal tumor shrinkage and survival was analyzed in Kaplan-Meier and Cox regression models with the landmark method. The specified landmark time points were 8 weeks, the median time to maximal tumor shrinkage (16.5 weeks), and median progression-free survival (PFS; 56 weeks).<bold>Results: </bold>A total of 76 patients (77%) responded to gefitinib or afatinib. Of these 76 patients, 49 (64%) and 75 (99%) had achieved a response at 8 and 16.5 weeks, respectively. All responders had achieved a response by 56 weeks. The responders had a significantly longer PFS and overall survival (OS) compared with those with stable disease at 16.5 weeks (PFS, P = .003; OS, P < .001) and 56 weeks (PFS, P = .026; OS, P = .016) but not at 8 weeks (PFS, P = .104; OS, P = .313). Among the responders, greater tumor shrinkage was not associated with longer PFS or OS.<bold>Conclusion: </bold>Those with a response to first-line gefitinib or afatinib had more favorable PFS and OS compared with those with stable disease. A sufficient observation period was required for the response to occur and predict outcomes. Greater maximal tumor shrinkage in the responders was not predictive of survival.
- Subjects
CELL receptors; LUNG cancer; LUNG tumors; GENETIC mutation; TREATMENT effectiveness; PROPORTIONAL hazards models; PROTEIN kinase inhibitors; KAPLAN-Meier estimator
- Publication
Clinical Lung Cancer, 2018, Vol 19, Issue 3, pe361
- ISSN
1525-7304
- Publication type
journal article
- DOI
10.1016/j.cllc.2018.01.005