Romina Sluga1, Ben E E M VAN DEN Borne2, Paul Roepman3, Bas J M Peters4, Elisabeth A Kastelijn5, Franz M N H Schramel6. 1. Department of Pulmonary Diseases, St. Antonius Hospital, Nieuwegein/Utrecht, the Netherlands/Santeon Care for Outcomes NSCLC Study Group, Santeon Hospital Group, Utrecht, the Netherlands r.sluga@antoniusziekenhuis.nl. 2. Department of Pulmonary Diseases, Catharina Hospital, Eindhoven, the Netherlands/Santeon Care for Outcomes NSCLC Study Group, Santeon Hospital Group, Utrecht, the Netherlands. 3. Department of Pathology, St. Antonius Hospital, Nieuwegein/Utrecht, the Netherlands/Santeon Care for Outcomes NSCLC Study Group, Santeon Hospital Group, Utrecht, the Netherlands. 4. Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein/Utrecht, the Netherlands/Santeon Care for Outcomes NSCLC Study Group, Santeon Hospital Group, Utrecht, the Netherlands. 5. Department of Pulmonary Diseases, Gelderse Vallei Hospital, Ede, the Netherlands. 6. Department of Pulmonary Diseases, St. Antonius Hospital, Nieuwegein/Utrecht, the Netherlands/Santeon Care for Outcomes NSCLC Study Group, Santeon Hospital Group, Utrecht, the Netherlands.
Abstract
BACKGROUND/AIM: Epidermal growth factor receptor (EGFR) mutation testing is standard-of-care for advanced non-small cell lung cancer (NSCLC). Outcomes of second-/third-line compared to first-line tyrosine kinase inhibitors (TKIs) have shown conflicting results. We investigated utilization of molecular diagnostics and the outcomes of treatment with first-/second-line TKIs in patients with advanced NSCLC. MATERIALS AND METHODS: Retrospective analysis was carried out of 2,206 patients with stage IIIb/IV NSCLC treated between 2008 and 2014 in four hospitals in the Netherlands. RESULTS: The rate of performing molecular diagnostics increased from 20.8% to 74.4% in the study period. The median overall survival of EGFR mutation-positive patients treated with TKIs was superior compared to EGFR mutation-negative patients treated with chemotherapy (720 vs. 274 days, p<0.0001). No difference in overall survival was found between EGFR mutation-positive patients treated only with TKIs compared to those treated with chemotherapy prior to TKIs, or upon progression under TKIs. CONCLUSION: The rate of EGFR testing has improved, increasing the number of patients eligible for targeted therapy. Chemotherapy, prior or subsequent to TKIs, for the treatment of EGFR mutation-positive patients, did not result in significantly better overall survival compared to that achieved with TKIs alone. Copyright
BACKGROUND/AIM: Epidermal growth factor receptor (EGFR) mutation testing is standard-of-care for advanced non-small cell lung cancer (NSCLC). Outcomes of second-/third-line compared to first-line tyrosine kinase inhibitors (TKIs) have shown conflicting results. We investigated utilization of molecular diagnostics and the outcomes of treatment with first-/second-line TKIs in patients with advanced NSCLC. MATERIALS AND METHODS: Retrospective analysis was carried out of 2,206 patients with stage IIIb/IV NSCLC treated between 2008 and 2014 in four hospitals in the Netherlands. RESULTS: The rate of performing molecular diagnostics increased from 20.8% to 74.4% in the study period. The median overall survival of EGFR mutation-positive patients treated with TKIs was superior compared to EGFR mutation-negative patients treated with chemotherapy (720 vs. 274 days, p<0.0001). No difference in overall survival was found between EGFR mutation-positive patients treated only with TKIs compared to those treated with chemotherapy prior to TKIs, or upon progression under TKIs. CONCLUSION: The rate of EGFR testing has improved, increasing the number of patients eligible for targeted therapy. Chemotherapy, prior or subsequent to TKIs, for the treatment of EGFR mutation-positive patients, did not result in significantly better overall survival compared to that achieved with TKIs alone. Copyright
Authors: Christine M Cramer-van der Welle; Lotte van Loenhout; Ben Eem van den Borne; Franz Mnh Schramel; Lea M Dijksman Journal: BMJ Open Date: 2021-01-15 Impact factor: 2.692