- 期刊
Comparison of Outcomes with First- and Second- Generation Epidermal Growth Factor Receptor Inhibitors in Lung Adenocarcinoma Patients in Real-World Practice
摘要
Introduction: Tyrosine kinase inhibitors (TKIs) are the current standard first-line treatment for advanced lung adenocarcinoma harboring epidermal growth factor receptor (EGFR) mutations. In real-world practice, comparing the efficacy and toxicity of the 2 generations of TKIs is an important subject. The aim of this study, therefore, was to observe the clinical outcomes and adverse events of both first-generation and second-generation TKIs in real-world practice. Methods: This study was conducted retrospectively using data collected at Mackay Memorial Hospital, Taipei, Taiwan, from January 1, 2013 to July 31, 2017. We analyzed progression-free survival (PFS) and overall survival (OS) to evaluate the effectiveness of first-and second-generation EGFR-TKIs in patients with EGFR mutations treated with first-line TKIs. Results: A total of 176 patients were enrolled, including 138 patients in the first-generation TKI group (gefitinib and erlotinib) and 38 in the second-generation TKI group (afatinib). In the multivariate Cox proportional hazard model, second-generation TKIs had better PFS (hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.42-0.97, p=0.036). However, OS was not statistically significantly different (HR: 0.66, 95% CI: 0.41-1.07, p=0.093). Furthermore, there was more folliculitis (second-generation TKI vs first-generation TKI: 68.4% vs. 47.6%, p=0.028), paronychia (60.5% vs. 16.1%, p＜0.001), stomatitis (36.8% vs. 6.3%, p＜0.001), and diarrhea (57.9% vs. 19.6%, p＜0.001) of any grade in the second-generation TKI group. Conclusion: The results of our study of real-world practice indicate that using second-generation TKIs yielded better PFS than first-generation TKIs at the cost of more side effects, especially folliculitis, paronychia, stomatitis and diarrhea.
延伸閱讀
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