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Comparative Study
. 2016 Jun 14;7(24):35803-35812.
doi: 10.18632/oncotarget.8130.

The comparison of outcomes from tyrosine kinase inhibitor monotherapy in second- or third-line for advanced non-small-cell lung cancer patients with wild-type or unknown EGFR status

Giuseppe Bronte  1 , Tindara Franchina  2 , Massimiliano Alù  3 , Giovanni Sortino  1 , Claudia Celesia  1 , Francesco Passiglia  1 , Giuseppina Savio  3 , Agata Laudani  3 , Alessandro Russo  2 , Antonio Picone  2 , Sergio Rizzo  1 , Michele De Tursi  4 , Elisabetta Gambale  4 , Viviana Bazan  1 , Clara Natoli  4 , Livio Blasi  3 , Vincenzo Adamo  2 , Antonio Russo  1
Affiliations
Comparative Study

The comparison of outcomes from tyrosine kinase inhibitor monotherapy in second- or third-line for advanced non-small-cell lung cancer patients with wild-type or unknown EGFR status

Giuseppe Bronte et al. Oncotarget. .

Abstract

Background: Second-line treatment for advanced non-small-cell lung cancer (NSCLC) patients includes monotherapy with a third-generation cytotoxic drug (CT) or a tyrosine kinase inhibitor (TKI). These options are the actual standard for EGFR wild-type (WT) status, as patients with EGFR mutations achieve greater benefit by the use of TKI in first-line treatment. Some clinical trials and meta-analyses investigated the comparison between CT and TKI in second-line, but data are conflicting.

Methods: We designed a retrospective trial to gather information about TKI sensitivity in comparison with CT. We selected from clinical records patients treated with at least 1 line of CT and at least 1 line of TKI. We collected data about age, sex, performance status, comorbidity, smoking status, histotype, metastatic sites, EGFR status, treatment schedule, better response and time-to-progression (TTP) for each line of treatment and overall survival (OS).

Results: 93 patients met selection criteria. Mean age 66,7 (range: 46-84). M/F ratio is 3:1. 39 EGFR-WT and 54 EGFR-UK. All patients received erlotinib or gefitinib as second-line treatment or erlotinib as third-line treatment. No TTP differences were observed for both second-line (HR:0,91; p = 0,6333) and third-line (HR:1.1; p = 0,6951) treatment (TKI vs CT). A trend of a benefit in OS in favor of 3rd-line TKI (HR:0,68; p = 0,11).

Conclusions: This study explores the role of TKIs in EGFR non-mutated NSCLC patients. OS analysis highlights a trend to a benefit in patients who received TKI in third-line, even if this result is statistically non-significant. Further analysis are needed to find an explanation for this observation.

Keywords: EGFR; chemotherapy; non-small-cell lung cancer; tyrosine kinase inhibitor.

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Conflict of interest statement

The authors declare no potential conflicts of interests.

Figures

Figure 1
Figure 1. Survival curves of TTP for second-line treatment (TKI vs CT)
Figure 2
Figure 2. Survival curves of TTP for third-line treatment (TKI vs CT)
Figure 3
Figure 3. Survival curves of OS for the comparison 3rd-line vs 2nd-line TKI
Figure 4
Figure 4. Survival curves of OS for the comparison CT-CT-TKI vs CT-TKI-CT
See this image and copyright information in PMC

References

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