PMID- 33707140 OWN - NLM STAT- MEDLINE DCOM- 20211221 LR - 20211221 IS - 0929-6646 (Print) IS - 0929-6646 (Linking) VI - 121 IP - 1 Pt 1 DP - 2022 Jan TI - Comparing survival and subsequent treatment of first-line tyrosine kinase inhibitors in patients of advanced lung adenocarcinoma with epidermal growth factor receptor mutation. PG - 170-180 LID - S0929-6646(21)00076-0 [pii] LID - 10.1016/j.jfma.2021.02.012 [doi] AB - BACKGROUND/PURPOSE: Three first-line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are widely available to treat advanced lung adenocarcinoma harboring EGFR mutation. However, studies comparing efficacy or effectiveness of these EGFR TKIs came out with inconclusive results. METHODS: In this real-world data analysis with a nationwide retrospective cohort design, adult patients with newly diagnosed advanced lung adenocarcinoma with EGFR mutation between 2011 and 2016, who received a first-line EGFR TKI, were included. Overall survival (OS) and time to next treatment (TTNT) were compared between patients receiving different EGFR TKIs after overlap weighting. RESULTS: We enrolled 10,431 patients, including 6,230, 2,359, and 1842 in gefitinib, erlotinib, and afatinib groups, respectively. The median (95% confidence interval [CI]) OS were 24.2 (22.9-26.2), 25.7 (24.0-27.9), and 29.1 (25.8-32.1) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p = 0.001). The hazard ratios (95% CI) for the afatinib group were 0.85 (0.74-0.98) and 0.91 (0.79-1.05) comparing with the gefitinib and erlotinib groups, respectively. The median (95% CI) TTNT were 10.9 (10.4-11.2), 11.7 (11.3-12.1), 13.4 (12.5-14.3) months for those receiving gefitinib, erlotinib, and afatinib, respectively (p < 0.001). The hazard ratios (95% CI) for the afatinib group were 0.79 (0.70-0.88) and 0.89 (0.79-1.00) comparing with the gefitinib and erlotinib groups, respectively. There were 6111 (59%) patients receiving subsequent therapies, and the majority of them received a second-line chemotherapy, particularly platinum-based chemotherapy. CONCLUSION: Afatinib, compared with gefitinib, might provide better effectiveness as the first-line targeted therapy for patients of advanced lung adenocarcinoma with EGFR mutation. CI - Copyright (c) 2021 Formosan Medical Association. Published by Elsevier B.V. All rights reserved. FAU - Huang, Ming-Yi AU - Huang MY AD - School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. FAU - Hsieh, Kun-Pin AU - Hsieh KP AD - School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Pharmacy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. FAU - Huang, Ru-Yu AU - Huang RY AD - National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan. FAU - Hung, Jen-Yu AU - Hung JY AD - Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. FAU - Chen, Li-Tzong AU - Chen LT AD - National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Division of Hematology and Oncology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. FAU - Tsai, Ming-Ju AU - Tsai MJ AD - Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: SiegfriedTsai@gmail.com. FAU - Yang, Yi-Hsin AU - Yang YH AD - School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan; National Institute of Cancer Research, National Health Research Institutes, Tainan, Taiwan. Electronic address: yhyang@nhri.edu.tw. LA - eng PT - Journal Article DEP - 20210309 PL - Singapore TA - J Formos Med Assoc JT - Journal of the Formosan Medical Association = Taiwan yi zhi JID - 9214933 RN - 0 (Protein Kinase Inhibitors) RN - EC 2.7.10.1 (ErbB Receptors) SB - IM MH - *Adenocarcinoma of Lung/drug therapy/genetics MH - ErbB Receptors/genetics MH - Humans MH - Mutation MH - Protein Kinase Inhibitors/therapeutic use MH - Retrospective Studies OTO - NOTNLM OT - Effectiveness OT - Erlotinib OT - Gefitinib OT - Targeted therapy OT - afatinib COIS- Declaration of competing interest LTC received honorariums from Eli Lilly, TTY Biopharm, Sanofi, SynCore Biotechnology, Astellas Pharma, PharmaEngine, and Ipsen, and also received study medications from TTY Biopharm, Syncore Biotechnology, and Celgene for other investigator-initiated trials. JYH received honorariums from Eli Lilly, Sanofi, Roche, AstraZeneca, Boehringer Ingelheim, Ono, and MSD. MJT received honorariums for lectures, which were not associated with this article, from AstraZeneca and Boehringer Ingelheim. The other authors have declared no conflicts of interest related to this article. EDAT- 2021/03/13 06:00 MHDA- 2021/12/22 06:00 CRDT- 2021/03/12 06:09 PHST- 2020/09/06 00:00 [received] PHST- 2021/02/07 00:00 [revised] PHST- 2021/02/17 00:00 [accepted] PHST- 2021/03/13 06:00 [pubmed] PHST- 2021/12/22 06:00 [medline] PHST- 2021/03/12 06:09 [entrez] AID - S0929-6646(21)00076-0 [pii] AID - 10.1016/j.jfma.2021.02.012 [doi] PST - ppublish SO - J Formos Med Assoc. 2022 Jan;121(1 Pt 1):170-180. doi: 10.1016/j.jfma.2021.02.012. Epub 2021 Mar 9.