Continuation of epidermal growth factor receptor tyrosine kinase inhibitor treatment prolongs disease control in non-small-cell lung cancers with acquired resistance to EGFR tyrosine kinase inhibitors
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Qi Chen1,2,3, Qi Quan1,2,3, Lingyu Ding1,2,3, Xiangchan Hong1,2,3, Ningning Zhou1,2,3, Ying Liang1,2,3, Haiying Wu1,2,3
1State Key Laboratory of Oncology in South China, Guangzhou, China
2Department of Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
3Collaborative Innovation Center of Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, China
Haiying Wu, e-mail: [email protected]
Keywords: non-small-cell lung cancer, acquired resistance, continuation of epidermal growth factor receptor tyrosine kinase inhibitors, beyond PD, local treatment
Received: April 21, 2015 Accepted: June 26, 2015 Published: July 09, 2015
Objectives: Patients with non-small-cell lung cancer (NSCLC) develop acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) after tumor regression. No approved targeted therapies are currently available after initial EGFR TKI treatment. This study investigated the efficacy of continuing EGFR TKI therapy with local treatments for patients with NSCLC and local progression or minimal/slow progression on TKI therapy.
Materials and Methods: Fifty-five patients with NSCLC treated with EGFR TKIs and developed acquired resistance to the drug were included. Initial response to target therapy, median progression free survival (PFS1), progression pattern, and first progression site were assessed. Median progression free survival to physician assessment progression (PFS2) and difference between PFS1 and PFS2 (PFS difference) were also recorded.
Results and Conclusion: PFS1 was 11.2 months, PFS2 was 20.3 months, and PFS difference was 8.3 months. Nineteen patients (34.5%) who manifested progression received local therapy, and 16 (28.6%) underwent rebiopsy after progression with six positive EGFR T790M mutations detected. Cox proportional hazards regression model showed that only the first line of treatment was significantly correlated with PFS difference. NSCLC patients with acquired resistance to EGFR TKIs could benefit from the same TKI therapy through months to years of disease control.
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