The survival rate comparison of non small cell lung carcinoma patients who are given by epidermal growth factor receptor-tyrosin kinase inhibitor and those given by first-line chemotherapy treatment
DOI:
https://doi.org/10.20956/nmsj.v6i2.18857Abstract
Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Wahidin Sudirohusodo hospital. Methods. This study is a retrospective study between 2017 to 2019 from the medical records of NSCLC patients who receive first-line chemotherapy and thise who recieve EGFR-TKI. Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day and or afatinib 1x40 mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued. Result. From 239 subject of NSCLC patients consisted of 135 patients who receive first-line chemotherapy, and 104 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are more than 40 years old (chemotherapy 124 (91.9%) and EGFR-TKI 101 (97.1%) with the male gender that dominates (chemotherapy 98 (72.6%), EGFR-TKI 64 (61.5%). Smoking patients who received first-line chemotherapy are 65.2% and 61.5% of EGFR-TKIs with chemotherapy highest IB (severe IB 28.9%) and for EGFR-TKI (moderate IB are 26.9%). 73.2% of adenocarcinoma histology type with a predominance of stage IV 86.6% (83.7% for chemotherapy and EGFR-TKI 90.4%). Survival rate of patients are 98,7% for 6 months survival, 1 year survival rate is 94.1% and 2 years survival rate of 24.3%. Median survival patients who receiving EGFR-TKI longer than they received first- line chemotherapy (21 months versus 20 months). The 18 months PFS showed that patients treated with EGFR-TKI were 15 months, while patients receiving chemotherapy was 11 months. (P 0.000). Conclusion. Survival rates in NSCLC patients with EGFR-TKI therapy had significantly the highest survival rates compared with all other chemotherapy. Progression was faster in patients with first-line chemotherapy than EGFR-TKI. The factors that most influence the survival rate is type of therapy with p value<0.05.
References
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7–30.
Syahruddin E, Hudoyo A, Jusuf A, Respons dan toleransi pasien adenokarsinoma paru stage III dan IV untuk pemberian kemoterapi dengan rejimenp Paclitaxel (Paxus®) plus carboplatin [Internet]. J Respi Indo [Internet]. 2010;30(2):105–11.
Rafiemanesh H, Mehtarpour M, Khani F, Hesami SM, Shamlou R, Towhidi F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis. 2016;8(6): 1094–102.
Soetandyo N, Hanafi AR, Agustini S, Sinulingga DT. Prognosis of advanced stage non-small-cell lung cancer patients receiving chemotherapy: Adenocarcinoma versus squamous cell carcinoma. Med J Indones. 2020;29(1):26–31.
Yarden Y. The EGFR family and its ligands in human cancer: Signalling mechanisms and therapeutic opportunities. Eur J Cancer. 2001;37(SUPPL. 4):3–8.
Chung C-H. EGFR tyrosine kinase inhibitor therapy for lung cancer treatments and their clinical outcomes: A cohort study in Taiwan. Oncol Lett. 2019 Dec;18(6):6090–100.
Tomasini P, Brosseau S, Mazières J, Merlio J-P, Beau-Faller M, Mosser J, et al. EGFR tyrosine kinase inhibitors versus chemotherapy in EGFR wild-type pre-treated advanced nonsmall cell lung cancer in daily practice [Internet]. Eur Respir J
Mok TS, Wu Y, Thongprasert S, Yang C, Saijo N, Sunpaweravong P, et al. Gefitinib or carboplatin-paclitaxel in Pulmonary Adenocarcinoma. N Engl J Med. 2009;361(september):947–57.
Kim ES, Hirsh V, Mok T, Socinski MA, Gervais R, Wu Y, et al. Gefi tinib versus docetaxel in previously treated non-small-cell lung cancer (INTEREST): a randomised phase III trial [Internet]. Lancet [Internet]. Elsevier Ltd; 1809;372(9652):1809–18.
Sandler AB, Nemunaitis J, Denham C, Von Pawel J, Cormier Y, Gatzemeier U, et al. Phase III trial of gemcitabine plus cisplatin versus cisplatin alone in patients with locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol. 2000;18(1):122–30.
Islam KMM, Jiang X, Anggondowati T, Lin G, Ganti AK. Comorbidity and survival in lung cancer patients. Cancer Epidemiol Biomarkers Prev. 2015;24(7):1079–85.
Syahruddin E, Marlina N, Hudoyo A. Efikasi dan Toksisitas Rejimen Sisplatin + Etoposid untuk Kemoterapi Kanker Paru Jenis Karsinoma Bukan Sel Kecil (KPKBSK) Stage Lanjut. 2012;32(1):25–35.
Lee N, Park H, Jong-ho W, Hong D, Uh S. Randomized, Multi-center Phase II Trial of Docetaxel Plus Cisplatin Versus Etoposide Plus Cisplatin as the First-line Therapy for Patients with Advanced Non-Small Cell Lung Cancer. 2005;37(6):332-8.
Tammemagi M, Neslund-Dudas C, Simoff M, Kvale P. Smoking and Lung Cancer Survival-The Role of Comorbidity and Treatment. Chest. 2004;125:27–37.
Inoue A, Suzuki T, Fukuhara T, Maemondo M, Kimura Y, Morikawa N, et al. Prospective phase II study of gefitinib for chemotherapy-naïve patients with advanced non-small-cell lung cancer with epidermal growth factor receptor gene mutations. J Clin Oncol. 2006;24(21):3340–6.
Irmer D, Funk JO, Blaukat A. EGFR kinase domain mutations - Functional impact and relevance for lung cancer therapy. Oncogene. 2007;26(39):5693–701
Rosell R. Erlotinib versus standard che-motherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012 Mar;13(3):239–46.
Crinò L, Dansin E, Garrido P, Griesinger F, Laskin J, Pavlakis N, et al. Safety and efficacy of first-line bevacizumab-based therapy in advanced non-squamous non-small-cell lung cancer (SAiL, MO19390): a phase 4 study. Lancet Oncol. England 2010 Aug;11(8):733–40.
Rigas JR, Kelly K. Current treatment paradigms for locally advanced non-small cell lung cancer [Internet]. J Thorac Oncol [Internet]. International Association for the Study of Lung Cancer; 2007;2(SUPPL. 2):S77–85.
Perhimpunan Dokter Paru Indonesia. kanker paru. pedoman diagnosis dan penatalaksanaan di Indonesia. 2016.
American Lung Association. State of lung disease in diverse communities 2017. New York. 2017;55–62.
O Fiala , M Pesek, J Finek, L Benesova, Z Bortlicek MM. Comparison of EGFR-TKI and chemotherapy in the first-line treatment of advanced EGFR mutation-positive NSCLC. Neoplasma. 2013;60(5):607–16.
Ou sai ignatius, Ziogas A, Zell jason A. Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer (NSCLC) and is independent of smoking status [Internet]. J Thorac Oncol [Internet]. J Thorac Oncol; 2009 [cited 2021 Oct 28];4(9):1083–93.
Lee CK, Davies L, Wu YL, Mitsudomi T, Inoue A, Rosell R, et al. Gefitinib or Erlotinib vs Chemotherapy for EGFR Mutation-Positive Lung Cancer: Individual Patient Data Meta-Analysis of Overall Survival. J Natl Cancer Inst. 2017;109(6):1–9.
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