Clinicopathological Characteristics and Real-life Data of Patients Receiving Tyrosine Kinase Inhibitor in Metastatic EGFR Mutant Non-small Cell Lung Carcinoma

Abstract

Aim: The desired survival times could not be achieved with conventional treatments in lung cancer. Tyrosine kinase inhibitors (TKIs) are used in the treatment of non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations. The aim of this study was to investigate the clinicopathologic features of EGFR mutant NSCLC patients and the effects of TKIs on progression-free survival (PFS) and overall survival (OS). Materials and Methods: A total of 61 patients who were admitted to Cerrahpaşa Faculty of Medicine, Department of Internal Medicine, Department of Medical Oncology, between 2012 and 2022, who were EGFR mutants with NSCLC and who used TKI as treatment were included in the study. Demographic and pathological characteristics of the patients, treatments used in the patients, progression and death dates were examined retrospectively. Results: Age at diagnosis, serum creatinine, last visit ECOG score and progression rate were significantly higher in the deceased group. The rate of T790M mutation and osimertinib use was significantly higher in the surviving group. Last visit ECOG score was significantly higher in the progression group. Survival time was significantly shorter in the group with visceral metastasis than in the group without visceral metastases, in the group with a last visit ECOG score II-III-IV compared to those with 0-I, and in the group without the T790M mutation than in the group with the T790M mutation. The progression-free survival time was significantly shorter in the group with ECOG score II-III-IV at the last visit compared to those with 0-I and in the group with visceral metastasis than in the group without. There was no statistically significant difference between erlotinib, afatinib and gefitinib in terms of PFS and OS. PFS calculated as 27.4 months and OS 49.2 months. The median PFS duration of 13 patients receiving osimertinib was calculated as 18.5 months. Conclusion: Age, diagnosis and ECOG performance score at the last visit, visceral metastasis at the beginning of TKI, T790M mutation and therefore osimertinib use had a significant effect on the OS, while on PFS, the significant effect of the visceral metastasis at TKI initiation, stage at the time of diagnosis, the ECOG performance score at the last visit was seen.

Keywords

• lung cancer
• egfr
• tyrosine kinase inhibitors