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Clinical model to predict progression-free survival in EGFR-mutant lung adenocarcinoma patients treated with first-generation EGFR-TKIs

  
@article{TCR8642,
	author = {Shaohua Cui and Liwen Xiong and Yuqing Lou and Huangping Shi and Aiqin Gu and Yizhuo Zhao and Tianqing Chu and Huimin Wang and Wei Zhang and Lili Dong and Liyan Jiang},
	title = {Clinical model to predict progression-free survival in EGFR-mutant lung adenocarcinoma patients treated with first-generation EGFR-TKIs},
	journal = {Translational Cancer Research},
	volume = {5},
	number = {4},
	year = {2016},
	keywords = {},
	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.},
	issn = {2219-6803},	url = {https://tcr.amegroups.org/article/view/8642}
}