Efficacy And Safety Of EGFR-Tyrosine Kinase Inhibitors In The Patiets With Advanced Non-Small Cell Lung Cancer Harboring Mutations Of The Epidermal Growth Factor Receptor

Objective:To investigate the efficacy and safety of EGFR-tyrosine kinase inhibitors in treatment of patients with advanced non-small cell lung cancer (NSCLC) harboring EGFR mutations.Methods:The clinical data of 101 patients who were admitted to Guangxi Tumor Hospital from April 4,2009 to June 12,2014 were retrospectively analyzed. All patients were given EGFR-tyrosine kinase inhibitors (including erlotinib, gefitinib, and icotinib) treatment. Of which 70 cases were treated as first line for EGFR-tyrosine kinase inhibitors,24cases as second-line,7 cases as three lines or more.Results:The objective response rate(ORR) was 60.4% and disease control rate(DCR) was 93.1%. Two complete response cases occurred. Median progression free survival (PFS) with EGFR-tyrosine kinase inhibitors treatment was 12.0months (95%C/:9.18 to 14.81). Median overall survival was 21 months (95%CI:13.99 to 28.00). Univariate analysis showed that first-line or second-line therapy with EGFR-tyrosine kinase inhibitors and low PS, non-smoking and female were associated with longer PFS. Especially, compared with smoking patients,non-smoking patients had longer PFS, p=0.015,the differences were statistically significant. Although,mutations in exon 19 had longer PFS compared with mutations in exon 21, but there was no statistical difference in PFS between mutations in exon 19 and exon 21. At least one drug related adverse event was observed in 59.4%(60/101) of patients, but mostly grade 1 or 2 was reversible,one patient occurred grade 3 rash and none grade 4 toxicity.Conclusion:1.The efficacy of small molecules EGFR tyrosine kinase inhibitors in the first-line treatment is as well as in the second-line treatment;2.The response rates between non-smoking and smoking are quite, but the non-smoking patients have longer PFS compared with smoking patients and there is statistical difference.3. The efficacy of exon 19 mutation is slightly better than exon 21 mutation,but there is no statistical difference.4.The use of EGFR-tyrosine kinase inhibitors in the treatment of patients with advanced non-small cell lung cancer (NSCLC) harboring EGFR mutations is efficacious and safe, and its toxicities are tolerable.