Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan;121(1 Pt 1):170-180.
doi: 10.1016/j.jfma.2021.02.012. Epub 2021 Mar 9.

Comparing survival and subsequent treatment of first-line tyrosine kinase inhibitors in patients of advanced lung adenocarcinoma with epidermal growth factor receptor mutation

Ming-Yi Huang  1 , Kun-Pin Hsieh  2 , Ru-Yu Huang  3 , Jen-Yu Hung  4 , Li-Tzong Chen  5 , Ming-Ju Tsai  6 , Yi-Hsin Yang  7
Affiliations
Free article

Comparing survival and subsequent treatment of first-line tyrosine kinase inhibitors in patients of advanced lung adenocarcinoma with epidermal growth factor receptor mutation

Ming-Yi Huang et al. J Formos Med Assoc. 2022 Jan.
Free article

Abstract

Background/purpose: Three first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are widely available to treat advanced lung adenocarcinoma harboring EGFR mutation. However, studies comparing efficacy or effectiveness of these EGFR TKIs came out with inconclusive results.

Methods: In this real-world data analysis with a nationwide retrospective cohort design, adult patients with newly diagnosed advanced lung adenocarcinoma with EGFR mutation between 2011 and 2016, who received a first-line EGFR TKI, were included. Overall survival (OS) and time to next treatment (TTNT) were compared between patients receiving different EGFR TKIs after overlap weighting.

Results: We enrolled 10,431 patients, including 6,230, 2,359, and 1842 in gefitinib, erlotinib, and afatinib groups, respectively. The median (95% confidence interval [CI]) OS were 24.2 (22.9-26.2), 25.7 (24.0-27.9), and 29.1 (25.8-32.1) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p = 0.001). The hazard ratios (95% CI) for the afatinib group were 0.85 (0.74-0.98) and 0.91 (0.79-1.05) comparing with the gefitinib and erlotinib groups, respectively. The median (95% CI) TTNT were 10.9 (10.4-11.2), 11.7 (11.3-12.1), 13.4 (12.5-14.3) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p < 0.001). The hazard ratios (95% CI) for the afatinib group were 0.79 (0.70-0.88) and 0.89 (0.79-1.00) comparing with the gefitinib and erlotinib groups, respectively. There were 6111 (59%) patients receiving subsequent therapies, and the majority of them received a second-line chemotherapy, particularly platinum-based chemotherapy.

Conclusion: Afatinib, compared with gefitinib, might provide better effectiveness as the first-line targeted therapy for patients of advanced lung adenocarcinoma with EGFR mutation.

Keywords: Effectiveness; Erlotinib; Gefitinib; Targeted therapy; afatinib.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest LTC received honorariums from Eli Lilly, TTY Biopharm, Sanofi, SynCore Biotechnology, Astellas Pharma, PharmaEngine, and Ipsen, and also received study medications from TTY Biopharm, Syncore Biotechnology, and Celgene for other investigator-initiated trials. JYH received honorariums from Eli Lilly, Sanofi, Roche, AstraZeneca, Boehringer Ingelheim, Ono, and MSD. MJT received honorariums for lectures, which were not associated with this article, from AstraZeneca and Boehringer Ingelheim. The other authors have declared no conflicts of interest related to this article.

MeSH terms

LinkOut - more resources