The association between clinical prognostic factors and epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) efficacy in advanced non-small-cell lung cancer patients: a retrospective assessment of 94 cases with EGFR mutations.

// Jing-Hui Lin 1, 2 , Dong Lin 1, 2 , Ling Xu 1, 2 , Qiang Wang 1, 2 , Hui-Hua Hu 1, 2 , Hai-Peng Xu 1, 2 , Zhi-Yong He 1, 2 1 Department of Thoracic Medical Oncology, Fujian Provincial Cancer Hospital & Cancer Hospital Affiliated to Fujian Medical University, Fuzhou 350014, Fujian Province, China 2 Group of Lung Cancer Treatment, Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou 350014, Fujian Province, China Correspondence to: Zhi-Yong He, email: zhiyonghecn@sina.com Keywords: non-small-cell lung cancer, epidermal growth factor receptor, epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), prognostic factor, retrospective analysis Received: July 05, 2016     Accepted: November 22, 2016     Published: December 03, 2016 ABSTRACT Objective: This study aimed to examine the association of clinical prognostic factors with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) efficacy in advanced non-small-cell lung cancer (NSCLC) patients. Methods: The demographic and clinical characteristics of 94 patients with stage IV NSCLC were retrospectively reviewed, and the association between clinical factors and EGFR-TKIs efficacy was evaluated. Results: Of the 94 stage IV NSCLC patients enrolled in this study, a 74.5% objective response rate (ORR) and 97.9% disease control rate (DCR) were observed for EGFR-TKIs treatment, and a higher ORR was seen in patients with 0 and 1 ECOG scores than those with 2 or greater scores ( P = 0.049). The subjects had a median PFS of 11 months and a median OS of 31 months after EGFR-TKIs treatment. ECOG score and timing of targeted therapy were factors affecting PFS, and ECOG score, smoking status and brain metastasis were factors affecting OS. In addition, ECOG score was an independent prognostic factor for PFS in stage IV NSCLC patients, and the patients with EGFR 19del mutation had a longer PFS than those with exon 21 L855R mutation ( P = 0.003), while ECOG score and brain metastasis were independent prognostic factors for OS. Conclusions: The results of this study demonstrate that EGFR-TKI therapy results in survival benefits for EGFR -mutant advanced NSCLC patients, regardless of gender, smoking history, pathologic type, type of EGFR mutations, brain metastasis and timing of targeted therapy. ECOG score is an independent prognostic factor for PFS, and ECOG score and brain metastasis are independent prognostic factors for OS in advanced NSCLC patients.