The Prognostic Value Of Platelet Count In The Treatment Of Non-small Cell Lung Cancer Patients With EGFR-TKIs

Objective: Progressive lung cancer is associated with abnormal coagulation.Platelets play a vital part in evading immune surveillance and angiogenesis in the case of tumor metastasis.The study aimed to analyze the predictive and prognostic effects of platelet count on non-small cell lung cancer(NSCLC)patients treated with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs).Methods: A total of 47 NSCLC patients with EGFR-TKIs treatment admitted to the First Affiliated Hospital of Anhui Medical University were enrolled.Clinical features,biochemical indexes,platelet count,together with the progression-free survival(PFS)and overall survival(OS)were collected before and after 2 cycles of treatments(60 days).The correlation between decreased platelet count and PFS,OS was analyzed retrospectively.Results: The anti-EGFR treatment markedly reduced the platelet count in 29(61.7%)patients after 2 cycles of treatment.Multivariate analysis revealed that,the decreased platelet count was closely correlated with the longer PFS(HR = 0.11;95%CI: 0.031-0.393;p = 0.001)and OS(HR = 0.007;95%CI: 0.000-0.235;p =0.005).Besides,the median PFS was 419 days in the decreased platelet count group and 278 days in the increased platelet count group(HR=0.606;95%CI: 0.332-1.106;P=0.102),whereas the median OS was 618 days and 517 days in the above two groups,respectively(HR=0.314;95%CI:0.119-0.828;P=0.019),as obtained from the independent baseline platelet levels and other clinical features.Conclusions: As a routine test item,the reduction of platelet count at no additional cost has been shown to predict the prognosis of non-small cell lung cancer patients treated with EGFR-TKIs.Therefore,changes in platelet count can serve as a meaningful parameter to establish a prognostic model for NSCLC patients receiving anti-EGFR targeted therapy...