Background and objective:Epidermal growth factor receptor(EGFR)mutations are often associated with non-EGFR genetic alterations,which maybe a reason for the poor efficacy of EGFR tyrosine kinase inhibitors(TKIs).Here we conducted this study to explore whether EGFR-TKIs combined with chemotherapy would benefit advanced lung adenocarcinoma patients with both sensitive EGFR mutation and concomitant non-EGFR genetic alterations.Materials and methods:Cases of advanced lung adenocarcinoma with EGFR mutation combined with concomitant non-EGFR genetic alterations were retrospectively collected.And the patients were required to receive first-line EGFR-TKIs and chemotherapy combination or EGFR-TKIs monotherapy.Demographic,clinical and pathological data were collected,and the electronic imaging data were retrieved to evaluate the efficacy and time of disease progression.Survival data were obtained through face-to-face or telephone follow-up.The differences between the two groups in objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and overall survival(OS)were investigated.Results:107 patients were included,including 63 cases in the combination group and 44 cases in the monotherapy group.The ORR were 78％and 50％(P=0.003),and DCR were 97％and 77％(P=0.002),respectively.At a median follow-up of 13.7 mon,a PFS event occurred in 38.1％and 81.8％of patients in the two groups,with median PFS of 18.8 mon and 5.3 mon,respectively(P＜0.000,1).Median OS was unreached in the combination group,and 27.8 mon in the monotherapy group(P=0.31).According to the Cox multivariate regression analysis,combination therapy was an independent prognostic factor of PFS.Conclusion:In patients with EGFR-mutant advanced lung adenocarcinoma with concomitant non-EGFR genetic alterations,combination of TKIs and chemotherapy was significantly superior to EGFR-TKIs monotherapy,which should be the preferred treatment option.

Guowei ZHANG;Ruirui CHENG;Yuanyuan NIU;Huijuan WANG;Xiangtao YAN;Mina ZHANG;Xiaojuan ZHANG;Jinpo YANG;Chunhua WEI;Zhiyong MA

Department of Internal Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Department of Respiratory Medicine,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China

中国肺癌杂志

[1]Guowei ZHANG;Ruirui CHENG;Yuanyuan NIU;Huijuan WANG;Xiangtao YAN;Mina ZHANG;Xiaojuan ZHANG;Jinpo YANG;Chunhua WEI;Zhiyong MA-.Efficacy Differences of First-line EGFR-TKIs Alone vs in Combination with Chemotherapy in Advanced Lung Adenocarcinoma Patients with Sensitive EGFR Mutation and Concomitant Non-EGFR Genetic Alterations)[J].中国肺癌杂志,2022(09):651-657

unreached

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