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. 2025 Jun 26;33(7):1667-1677.
doi: 10.32604/or.2025.061905. eCollection 2025.

Tyrosine kinase inhibitors in first-line treatment of advanced NSCLC with epidermal growth factor receptor mutations: Real-world data from Vietnam

Khanh Toan Nguyen  1 , Thi Huong Pham  1 , VAN Lam Ngo  1 , VAN Tuan Bui  1 , VAN Nhat Nguyen  1 , Thi Phuong Thao Nguyen  1 , Thi Khanh Ha Nguyen  1 , Thi Thuy VAN Nguyen  1
Affiliations

Tyrosine kinase inhibitors in first-line treatment of advanced NSCLC with epidermal growth factor receptor mutations: Real-world data from Vietnam

Khanh Toan Nguyen et al. Oncol Res. .

Abstract

Aims: The study aimed to evaluate the effectiveness and adverse events of tyrosine kinase inhibitors (TKIs) in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations.

Methods: A retrospective study on advanced NSCLC patients with EGFR mutations treated with TKIs as a first-line therapy at Nghe An Oncology Hospital, Vietnam between January 2017 and August 2023. The primary endpoints included objective response rate, progression-free survival, and tolerability. The secondary endpoint was overall survival.

Results: A total of 211 patients received first-line treatment with Erlotinib (n = 74), Gefitinib (n = 85), Afatinib (n = 34) or Osimertinib (n = 18). The overall response rate was 76.7%, with Osimertinib at 83.4%, Afatinib at 73.6%, Erlotinib at 77.1%, and Gefitinib at 76.5%. The median progression-free survival in the Gefitinib group was 12.2 months (95% CI: 11.1-13.2), 13.4 months (95% CI: 10.6-16.2) in the Erlotinib group, 18.4 months (95% CI: 10.1-26.8) in the Afatinib group and 25.3 months in the Osimertinib group (p = 0.001). The median overall survival was 21.8 months (95% Cl: 15.0-28.4) in the Gefitinib group, 30 months (95% Cl: 19.1-40.9) in the Erlotinib group (p = 0.154). Most drug-related adverse events were grade 1 or 2. Diarrhea was the most frequent adverse event in the Afatinib group at 44.1%; rash was most common in the Erlotinib group at 60.8%; paronychia (31.8%), and interstitial lung disease (3.5%) were most frequent in the Gefitinib group.

Conclusion: The TKIs as first-line therapies for advanced NSCLC patients with EGFR mutated are highly effective, prolong survival, and are well tolerated.

Keywords: Afatinib; EGFR; Erlotinib; Gefitinib; Non-small-cell lung cancer; Osimertinib.

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Conflict of interest statement

The authors declare no conflicts of interest to report regarding the present study.

Figures

Figure 1
Figure 1. The flowchart of patient collection.
Figure 2
Figure 2. Subsequent therapies in patients who discontinued first-line.
Figure 3
Figure 3. The Kaplan-Meier curve of PFS (A) and OS (B) for TKI drug groups.
See this image and copyright information in PMC

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