Effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy on progression-free survival in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation

GAO Qingling; CHANG Yan; WANG Jingni; ZHANG Jing; SUN Qingke

doi:10.7619/jcmp.20233042

Journal of Clinical Medicine in Practice > 2023 > 27(24): 1-6. > DOI: 10.7619/jcmp.20233042

GAO Qingling, CHANG Yan, WANG Jingni, ZHANG Jing, SUN Qingke. Effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy on progression-free survival in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation[J]. Journal of Clinical Medicine in Practice, 2023, 27(24): 1-6. DOI: 10.7619/jcmp.20233042

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Effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy on progression-free survival in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation

Department of Oncology, the Second People's Hospital of Jincheng City in Shanxi Province, Jincheng, Shanxi, 048000

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Received Date: September 22, 2023
Revised Date: November 05, 2023
Available Online: January 04, 2024

Graphical Abstract

Abstract

Abstract

Objective
To explore the effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) combined with chemotherapy on progression-free survival (PFS) in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation.
Methods
A total of 110 advanced NSCLC patients with EGFR mutation in our hospital from January 2019 to April 2021 were selected as research objects. According to different therapeutic plans, they were divided into group A with 37 cases (anlotinib chemotherapy), group B with 32 cases (icotinib chemotherapy) and group C with 41 cases (anlotinib plus icotinib and chemotherapy). The short-term effect, levels of vascular growth factors before and after treatment, and the incidence of adverse reactions were compared among the three groups. After 2 years of follow-up, survival curve was drawn by Kaplan-Meier method, and survival rate and PFS were compared in three groups by Log-rank.
Results
The objective response rate (ORR) was 68.29% in the group C, which was significantly higher than 43.24% in the group A and 40.62% in the group B (P < 0.05); after treatment, levels of serum vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) in the group C were significantly lower than those in the group A and the group B (P < 0.05); the total incidence of adverse reactions was 29.27% in the group C, which showed no significant differences when compared to 24.32% in the group A and 25.00% in the group B (P>0.05). By the time of the last follow-up, the 2-year overall survival rate was 74.29% in the group C, which was significantly higher than 51.09% in the group A and 45.03% in the group B (Log-rank χ²=6.478, P=0.039); the median PFS in the group A, the group B and the group C was 9.0, 8.6 and 13.2 months respectively, and differences were statistically significant (Log-rank χ²=6.264, P=0.043).
Conclusion
For the advanced NSCLC patients with EGFR mutations, combination medication of EGFR-TKI combined with chemotherapy can effectively increase ORR, reduce levels of serum vascular growth factors, prolong the PFS, and the safety is good.

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References (28)

References

[1]	MARIAM A, YEON K S, CHENG H Y. Update 2020: management of non-small cell lung cancer[J]. Lung, 2020, 198(6): 897-907. doi: 10.1007/s00408-020-00407-5
[2]	PATEL S A, WEISS J. Advances in the treatment of non-small cell lung cancer: immunotherapy[J]. Clin Chest Med, 2020, 41(2): 237-247. doi: 10.1016/j.ccm.2020.02.010
[3]	辜群利, 李晖, 陈婧. 抗血管生成疗法在肝纤维化肝硬化和肝细胞癌中的应用进展[J]. 医药导报, 2022, 41(1): 92-98.
[4]	廉莹莹, 孙菲, 于静萍. 肿瘤相关巨噬细胞对肿瘤新生血管生成的作用及其机制的研究进展[J]. 癌症进展, 2022, 20(5): 433-436.
[5]	SANKAR K, GADGEEL S M, QIN A. Molecular therapeutic targets in non-small cell lung cancer[J]. Expert Rev Anticancer Ther, 2020, 20(8): 647-661. doi: 10.1080/14737140.2020.1787156
[6]	KASHIMA Y, SHIBAHARA D, SUZUKI A, et al. Single-cell analyses reveal diverse mechanisms of resistance to EGFR tyrosine kinase inhibitors in lung cancer[J]. Cancer Res, 2021, 81(18): 4835-4848. doi: 10.1158/0008-5472.CAN-20-2811
[7]	NAGASAKA M, ZHU V W, LIM S M, et al. Beyond osimertinib: the development of third-generation EGFR tyrosine kinase InhibitorsFor advanced EGFR+ NSCLC[J]. J Thorac Oncol, 2021, 16(5): 740-763. doi: 10.1016/j.jtho.2020.11.028
[8]	郑乐, 陈俊. 联合治疗方案对晚期非小细胞肺癌患者预后及免疫功能的影响[J]. 实用临床医药杂志, 2021, 25(10): 52-56. doi: 10.7619/jcmp.20210794
[9]	中华医学会, 中华医学会肿瘤学分会, 中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2019版)[J]. 肿瘤研究与临床, 2020, 32(4): 217-249.
[10]	LALCHANDANI U R, SAHAI V, HERSBERGER K, et al. A radiologist's guide to response evaluation criteria in solid tumors[J]. Curr Probl Diagn Radiol, 2019, 48(6): 576-585. doi: 10.1067/j.cpradiol.2018.07.016
[11]	REMON J, SORIA J C, PETERS S, et al. Early and locally advanced non-small-cell lung cancer: an update of the ESMO Clinical Practice Guidelines focusing on diagnosis, staging, systemic and local therapy[J]. Ann Oncol, 2021, 32(12): 1637-1642. doi: 10.1016/j.annonc.2021.08.1994
[12]	NOOR Z S, CUMMINGS A L, JOHNSON M M, et al. Targeted therapy for non-small cell lung cancer[J]. Semin Respir Crit Care Med, 2020, 41(3): 409-434. doi: 10.1055/s-0039-1700994
[13]	HE J Y, HUANG Z R, HAN L Z, et al. Mechanisms and management of 3rd-generation EGFR-TKI resistance in advanced non?small cell lung cancer (Review)[J]. Int J Oncol, 2021, 59(5): 90. doi: 10.3892/ijo.2021.5270
[14]	CHEN Y Z, WEN S D, WU Y, et al. Efficacy and safety of first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) combined with chemotherapy or antiangiogenic therapy as first-line treatment in patients with EGFR-mutant non-small cell lung cancer: a systematic review and meta-analysis[J]. Crit Rev Oncol Hematol, 2021, 163: 103393. doi: 10.1016/j.critrevonc.2021.103393
[15]	SUDA K, MITSUDOMI T. Drug tolerance to EGFR tyrosine kinase inhibitors in lung cancers with EGFR mutations[J]. Cells, 2021, 10(7): 1590. doi: 10.3390/cells10071590
[16]	FUJINO T, SUDA K, MITSUDOMI T. Emerging MET tyrosine kinase inhibitors for the treatment of non-small cell lung cancer[J]. Expert Opin Emerg Drugs, 2020, 25(3): 229-249. doi: 10.1080/14728214.2020.1791821
[17]	姜伟华, 高永山, 容宇, 等. 阿法替尼与埃克替尼联合TP化疗治疗晚期EGFR突变型非小细胞肺癌的比较研究[J]. 现代药物与临床, 2023, 38(1): 142-146.
[18]	郝娟, 周光华, 陈忆玲. EGFR-TKI靶向联合放疗、化疗治疗Ⅳ期EGFR突变型非小细胞肺癌的临床效果[J]. 湖南师范大学学报: 医学版, 2021, 18(2): 109-112.
[19]	郭慧锦, 刘艺婧, 王茜, 等. 不同EGFR敏感突变类型晚期NSCLC埃克替尼单药/联合化疗的疗效对比研究[J]. 南京医科大学学报: 自然科学版, 2021, 41(8): 1196-1202.
[20]	XIONG Q, QIN B Y, XIN L L, et al. Real-world efficacy and safety of anlotinib with and without immunotherapy in advanced non-small cell lung cancer[J]. Front Oncol, 2021, 11: 659380. doi: 10.3389/fonc.2021.659380
[21]	李春姗, 王家晓, 石玮, 等. 埃克替尼与安罗替尼治疗晚期非小细胞肺癌疗效比较及对miR-185-5p、miR-204-5p表达水平影响观察[J]. 中国药师, 2020, 23(12): 2409-2411.
[22]	王秋桐, 吴爽, 刘颖, 等. 抗血管生成药物靶向治疗进展期非小细胞肺癌的临床研究进展[J]. 中国新药与临床杂志, 2022, 41(2): 71-78.
[23]	陈华林, 杨东红, 罗怡平, 等. 埃克替尼联合化疗治疗EGFR突变型晚期非小细胞肺癌的疗效及对生活质量和血清肿瘤标志物的影响[J]. 现代生物医学进展, 2021, 21(6): 1138-1142.
[24]	孙虎, 冯慧晶, 杨晓玲, 等. 贝伐珠单抗联合奥希替尼治疗EGFR突变晚期NSCLC的疗效及对血管生长因子水平的影响[J]. 川北医学院学报, 2022, 37(11): 1423-1427.
[25]	王玲, 杜倩宇, 王西勇. 安罗替尼联合化疗治疗驱动基因阴性晚期非小细胞肺癌的疗效及对血清VEGF、bFGF、MMP-9水平的影响[J]. 临床和实验医学杂志, 2022, 21(1): 39-43.
[26]	林莉榕, 赖丽君, 沈春梅. 安罗替尼联合多西他赛治疗晚期非小细胞肺癌的临床效果[J]. 临床合理用药杂志, 2022, 15(28): 31-34, 37.
[27]	中国医师协会肿瘤医师分会, 中国临床肿瘤学会血管靶向治疗专家委员会, 中国抗癌协会肿瘤靶向治疗专业委员会. 盐酸安罗替尼治疗晚期肺癌中国专家共识(2020版)[J]. 中华肿瘤杂志, 2020, 42(10): 807-816.
[28]	江舟, 陈建华. 安罗替尼联合埃克替尼治疗ⅢB/Ⅳ期EGFR基因突变型非小细胞肺癌患者的疗效及安全性[J]. 医学临床研究, 2022, 39(7): 1002-1005, 1009.

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Effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy on progression-free survival in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation