Original Article
Clinical model to predict progression-free survival in EGFR-mutant lung adenocarcinoma patients treated with first-generation EGFR-TKIs
Abstract
Background: Albeit epidermal growth factor receptor (EGFR) mutation status might be superior to other clinical and pathological factors for predicting response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), the efficacy might differ a lot in patients with the same EGFR sensitive mutations. Thus, exploring factors associated with EGFR-TKIs efficacy other than EGFR mutation status is vital, especially in patients with EGFR-activating mutations.
Methods: The present study retrospectively collected clinical and pathological data on a total of 128 patients with EGFR-activating lung adenocarcinoma who received first-generation EGFR-TKIs (including gefitinib, erlotinib or icotinib). Kaplan-Meier and Cox regression methods were applied to identify independent factors associated with progression-free survival (PFS) and to generate a prognostic index (PI) model.
Results: The median PFS of the 128 patients was 14.9 months (95% CI, 13.2–16.5 months). A non-smoking history [hazard ratio (HR) =2.896; 95% CI, 1.501–5.558; P=0.002] and first-line EGFR-TKIs treatment (HR, 1.544; 95% CI, 0.999–2.386; P=0.05) were found to be independent predictive factors of a longer PFS with EGFR-TKIs therapy. Predictive model can be established as PI =1.063 × Smoking + 0.434 × Timing according to the results of Cox regression. Further analysis using the PI model indicated that there are differences of three groups in PFS: non-smoking and first-line therapy, non-smoking and non-first-line therapy, smoking regardless of treatment timing.
Conclusions: The findings of the present study suggest that a non-smoking history and a first-line EGFR-TKIs treatment timing are independent predictors of a longer PFS in EGFR-mutant lung adenocarcinoma patients treated with first-generation EGFR-TKIs. PFS is longer for those who are never smokers and receive first-line EGFR-TKIs, compared with other groups.
Methods: The present study retrospectively collected clinical and pathological data on a total of 128 patients with EGFR-activating lung adenocarcinoma who received first-generation EGFR-TKIs (including gefitinib, erlotinib or icotinib). Kaplan-Meier and Cox regression methods were applied to identify independent factors associated with progression-free survival (PFS) and to generate a prognostic index (PI) model.
Results: The median PFS of the 128 patients was 14.9 months (95% CI, 13.2–16.5 months). A non-smoking history [hazard ratio (HR) =2.896; 95% CI, 1.501–5.558; P=0.002] and first-line EGFR-TKIs treatment (HR, 1.544; 95% CI, 0.999–2.386; P=0.05) were found to be independent predictive factors of a longer PFS with EGFR-TKIs therapy. Predictive model can be established as PI =1.063 × Smoking + 0.434 × Timing according to the results of Cox regression. Further analysis using the PI model indicated that there are differences of three groups in PFS: non-smoking and first-line therapy, non-smoking and non-first-line therapy, smoking regardless of treatment timing.
Conclusions: The findings of the present study suggest that a non-smoking history and a first-line EGFR-TKIs treatment timing are independent predictors of a longer PFS in EGFR-mutant lung adenocarcinoma patients treated with first-generation EGFR-TKIs. PFS is longer for those who are never smokers and receive first-line EGFR-TKIs, compared with other groups.
