The Impact of Sequence of Chemotherapy and EGFR-TKI Treatment on Different EGFR Mutation Lung Adenocarcinoma

الملخص EN

Objectives.

Chemotherapy as first-/second-line treatment in different epidermal growth factor receptor (EGFR) mutation lung adenocarcinoma remains controversial.

Methods.

Consecutive patients were collected between 2009 and 2012.

Patients were divided into two groups (1st-line chemotherapy: n = 56 and 2nd-line chemotherapy: n = 55).

Their outcomes profiles were analyzed.

Results.

The overall survival (OS) of all patients (390 versus 662 days, p < 0.0001), as well as both progression-free survival (PFS, 151 versus 252 days, p = 0.0001) and OS (308 versus 704 days, p = 0.0001) of patients with L858R mutation (n = 63), who received 2nd-line chemotherapy, was significantly poor.

By univariate and multivariate analysis, 2nd-line chemotherapy, and L858R mutation were significantly related to poor PFS and OS.

Conclusion.

In advanced lung adenocarcinoma, L858R mutation and 2nd-line chemotherapy caused a poor outcome.

It is a consideration to choice of 1st-line chemotherapy in these subjects.

A prospective design is warranted to confirm this finding.