Abstrakt

Survival of patients with advanced NSCLC treated with first-generation EGFR-TKIs at a cancer hospital in Thailand, 2011-2016.

Sitthi Sukauichai, Chokaew Tovanabutra, Sirentra Wanglikitkul, Kittisak Chomprasert

Objective: The present study was to determine survival of the patients with advanced Non-Small Cell Lung Cancer (NSCLC) treated with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) at Chonburi Cancer Hospital (CCH). Material and Methods: The study was conducted retrospectively by review of medical records of stage IIIB-IV NSCLC patients treated with first-generation EGFR-TKIs at CCH from January, 2011- December, 2016. Results: The present study enrolled 50 patients with median follow up time 16.78 months. The median age of patients was 58.5. There were female (46%), non-smoking (62%) and adenocarcinoma (90%). The sources of EGFR-TKI were a reimbursement system (32%), purchase for themselves (52%) and free drug samples (14%). Eastern Cooperative Oncologic Group (ECOG) performance status was 0-1 (54%), 2-4 (28%) and Non-Available (NA) (18%). The median Overall Survival (OS) of all patients were 17.18 months. The OS of the patients receiving EGFR-TKIs as first-line or maintenance (n=18), second-line (n=18) and third-line or more (n=14) were 15.86 (95%CI, 10.26-21.46), 10.87 (95%CI, 0.00-28.29) and 20.23 (95%CI, 6.26-34.21) (p=0.392) months, respectively. Regarding EGFR status, the OS of patients with EGFR sensitizing-mutation (22%), wild-type (12%) and unknown (66%) were 30.75 (95% CI,13.76-47.74), 7.91 (95% CI, 0.00-20.45) and 13.99 (95%CI, 9.17-18.82) (p=0.086) months, respectively. Multivariate analysis indicated that smoking (p=0.006), ECOG performance status 2-4 and NA (p<0.001), receiving EGFR-TKIs by payment (p=0.040) and compassionate use (p<0.001) were the unfavorable prognostic factors for the OS. Conclusion: In spite of the fact that most of the patients started an EGFR-TKI before their EGFR status was confirmed and often received it as a second-line or more. The OS of patients harbouring EGFR sensitizing-mutation in the present study was comparable to those of other pivotal studies.