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A Retrospective Study of Stage I to IIIa Lung Adenocarcinoma After Resection: What Is the Optimal Adjuvant Modality for Patients With an EGFR Mutation?
Lv, Chao1; An, Chao1; Feng, Qin2; Ma, Yuanyuan1; Li, Shaolei1; Wang, Jia1; Zhang, Jianzhi1; Wang, Xing1; Yan, Shi1; Fang, Jian3; Wang, Yinxiang4; Tan, Fenlai4; Yang, Yue1
关键词Adjuvant therapy Chemotherapy Disease-free survival EGFR-TKI Non-small-cell lung cancer
刊名CLINICAL LUNG CANCER
2015-11-01
DOI10.1016/j.cllc.2015.04.002
16期:6页:E173-E181
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology
研究领域[WOS]Oncology
关键词[WOS]GROWTH-FACTOR RECEPTOR ; VINORELBINE PLUS CISPLATIN ; TYROSINE KINASE INHIBITORS ; 1ST-LINE TREATMENT ; GENE-MUTATIONS ; ASIAN PATIENTS ; PHASE-3 TRIAL ; OPEN-LABEL ; CANCER ; CHEMOTHERAPY
英文摘要

We retrospectively reviewed a total of 257 stage I to IIIa lung adenocarcinoma after resection, tested them for the epidermal growth factor receptor (EGFR) mutation, and analyzed the effect of perioperative treatment on survival. The results showed that in patients with an EGFR mutation, adjuvant EGFR-tyrosine kinase inhibitor monotherapy after complete resection significantly prolongs disease-free survival compared with adjuvant chemotherapy and/or radiotherapy.

Background: Adjuvant cisplatin-based chemotherapy improves non-small-cell lung cancer (NSCLC) 5-year survival rates after resection. However, adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) efficacy and the optimal adjuvant treatment are unclear. Patients and Methods: The clinical records of patients tested for EGFR mutation after complete NSCLC resection were reviewed and tested for significance; EGFR mutation and adjuvant therapy effects on survival were assessed using univariate and Cox regression analyses. Results: We enrolled 257 patients (stage I, 126; stage II-IIIa, 131); 138 had EGFR mutation. EGFR mutation status was unrelated to recurrence (hazard ratio [HR], 0.83; 95% confidence interval [CI], 0.572-1.204; P = .326) or death (HR, 0.679; 95% CI, 0.406-1.136; P = .14). Thirty-one patients with EGFR mutation received adjuvant EGFR-TKIs; most (87.1%) received EGFR-TKI monotherapy. Patients who received adjuvant EGFR-TKIs had longer disease-free survival (DFS) than those who did not (P = .033) or received conventional adjuvant chemotherapy (P = .038). Adjuvant EGFR-TKIs did not affect overall survival (OS; P = .258), although the recipients had better 3-year OS (92.5% vs. 81%). Eight patients who received adjuvant EGFR-TKI developed disease recurrence, which occurred in 7 patients during adjuvant treatment. In the adjuvant EGFR-TKI group patients with a primary tumor EGFR mutation, EGFR mutation in the corresponding metastatic lymph nodes did not affect DFS, but patients who received EGFR-TKI after recurrence had longer progression-free survival (P = .087). Conclusion: In patients with an EGFR mutation, adjuvant EGFR-TKI monotherapy after complete resection significantly prolongs DFS compared with adjuvant chemotherapy and/or radiotherapy.

语种英语
WOS记录号WOS:000363267500006
项目编号2014AA020602
资助机构PKU 985 Special Funding for Collaborative Research with PKU Hospitals ; National High Technology Research and Development Program of China (863 Program)
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/61238
专题北京大学临床肿瘤学院_胸外科
北京大学临床肿瘤学院_胸部肿瘤外二科
北京大学临床肿瘤学院_乳腺癌预防治疗中心
北京大学临床肿瘤学院_病理科
作者单位1.Peking Univ Canc Hosp & Inst, Dept Thorac Surg 2, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing 100142, Peoples R China
2.Peking Univ Canc Hosp & Inst, Dept Pathol, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing 100142, Peoples R China
3.Zhejiang Beta Pharma Inc, Hangzhou, Zhejiang, Peoples R China
4.Peking Univ Canc Hosp & Inst, Dept Thorac Med Oncol 2, Key Lab Carcinogenesis & Translat Res, Minist Educ, Beijing 100142, Peoples R China
推荐引用方式
GB/T 7714
Lv, Chao,An, Chao,Feng, Qin,et al. A Retrospective Study of Stage I to IIIa Lung Adenocarcinoma After Resection: What Is the Optimal Adjuvant Modality for Patients With an EGFR Mutation?[J]. CLINICAL LUNG CANCER,2015,16(6):E173-E181.
APA Lv, Chao.,An, Chao.,Feng, Qin.,Ma, Yuanyuan.,Li, Shaolei.,...&Yang, Yue.(2015).A Retrospective Study of Stage I to IIIa Lung Adenocarcinoma After Resection: What Is the Optimal Adjuvant Modality for Patients With an EGFR Mutation?.CLINICAL LUNG CANCER,16(6),E173-E181.
MLA Lv, Chao,et al."A Retrospective Study of Stage I to IIIa Lung Adenocarcinoma After Resection: What Is the Optimal Adjuvant Modality for Patients With an EGFR Mutation?".CLINICAL LUNG CANCER 16.6(2015):E173-E181.
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