PMID- 36525509
OWN - NLM
STAT- MEDLINE
DCOM- 20230203
LR  - 20230404
IS  - 1759-7714 (Electronic)
IS  - 1759-7706 (Print)
IS  - 1759-7706 (Linking)
VI  - 14
IP  - 4
DP  - 2023 Feb
TI  - The survival after discontinuation of EGFR-TKIs due to intolerable adverse events 
      in patients with EGFR-mutated non-small cell lung cancer.
PG  - 348-356
LID - 10.1111/1759-7714.14674 [doi]
AB  - BACKGROUND: Epidermal growth factor receptor-tyrosine kinase inhibitors 
      (EGFR-TKIs) are standard treatments for advanced non-small cell lung cancer 
      (NSCLC) patients harboring the EGFR mutation. Patients experiencing intolerable 
      adverse events (AEs) would discontinue EGFR-TKIs. This study aimed to evaluate 
      the impact of intolerable AEs and subsequent treatment on the survival of 
      patients who discontinued EGFR-TKIs. PATIENTS: The data of advanced NSCLC 
      patients treated with EGFR-TKIs as frontline treatment at Chang Gung Memorial 
      Hospitals from June 2014 to March 2018 were retrospectively reviewed. RESULTS: A 
      total of 2190 patients were enrolled and treated with frontline EGFR-TKIs. In 
      August 2021, 114 (5.2%) patients experienced intolerable AEs requiring 
      discontinuation of EGFR-TKIs. The time median of EGFR-TKIs discontinuation was 
      2.56 months. Age >65 years, females, body weight, and body surface area were 
      associated with the occurrence of intolerable AEs for patients treated with 
      afatinib. Patients experiencing skin/paronychia/mucositis and abnormal liver 
      function test had favorable survivals results. Patients who received subsequent 
      EGFR-TKIs treatment, experienced better progression-free survival (PFS), total 
      PFS (from frontline line EGFR-TKIs), and overall survival (OS) compared to 
      patients receiving chemotherapy or no treatment. Patients undergoing subsequent 
      EGFR-TKIs had better total PFS (median, 14.9 vs. 11.3 months, p = 0.013) and OS 
      (median, 31.3 vs. 20.1 months, p = 0.001) than patients who did not discontinue 
      because of AEs. Favorable OS was validated by propensity score matching. 
      CONCLUSION: Patients experiencing intolerable AEs during EGFR-TKI treatment 
      should consider switching to an alternative EGFR-TKI, which increase the survival 
      results as compared to those patients who did not experience intolerable AEs.
CI  - (c) 2022 The Authors. Thoracic Cancer published by China Lung Oncology Group and 
      John Wiley & Sons Australia, Ltd.
FAU - Chang, John Wen-Cheng
AU  - Chang JW
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
FAU - Chang, Ching-Fu
AU  - Chang CF
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
FAU - Huang, Chen-Yang
AU  - Huang CY
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
FAU - Yang, Cheng-Ta
AU  - Yang CT
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
AD  - Division of Thoracic Oncology, Department of Thoracic Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
FAU - Kuo, Chih-Hsi Scott
AU  - Kuo CS
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
AD  - Division of Thoracic Oncology, Department of Thoracic Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
FAU - Fang, Yueh-Fu
AU  - Fang YF
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
AD  - Division of Thoracic Oncology, Department of Thoracic Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
FAU - Hsu, Ping-Chih
AU  - Hsu PC
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
AD  - Division of Thoracic Oncology, Department of Thoracic Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
FAU - Wu, Chiao-En
AU  - Wu CE
AUID- ORCID: 0000-0002-1081-8805
AD  - Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung 
      Memorial Hospital at Linkou, Taoyuan, Taiwan.
AD  - Chang Gung University College of Medicine, Taoyuan, Taiwan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20221216
PL  - Singapore
TA  - Thorac Cancer
JT  - Thoracic cancer
JID - 101531441
RN  - 0 (Protein Kinase Inhibitors)
RN  - EC 2.7.10.1 (ErbB Receptors)
RN  - EC 2.7.10.1 (EGFR protein, human)
SB  - IM
MH  - Female
MH  - Humans
MH  - Aged
MH  - *Carcinoma, Non-Small-Cell Lung/drug therapy/genetics
MH  - *Lung Neoplasms/drug therapy/genetics
MH  - Retrospective Studies
MH  - Protein Kinase Inhibitors/adverse effects
MH  - Disease-Free Survival
MH  - ErbB Receptors
MH  - Mutation
PMC - PMC9891857
OTO - NOTNLM
OT  - EGFR mutation
OT  - EGFR-TKIs
OT  - intolerable adverse events
OT  - lung cancer
COIS- The authors declare no conflict of interest.
EDAT- 2022/12/17 06:00
MHDA- 2023/02/04 06:00
PMCR- 2022/12/16
CRDT- 2022/12/16 14:04
PHST- 2022/09/13 00:00 [revised]
PHST- 2022/07/19 00:00 [received]
PHST- 2022/09/13 00:00 [accepted]
PHST- 2022/12/17 06:00 [pubmed]
PHST- 2023/02/04 06:00 [medline]
PHST- 2022/12/16 14:04 [entrez]
PHST- 2022/12/16 00:00 [pmc-release]
AID - TCA14674 [pii]
AID - 10.1111/1759-7714.14674 [doi]
PST - ppublish
SO  - Thorac Cancer. 2023 Feb;14(4):348-356. doi: 10.1111/1759-7714.14674. Epub 2022 
      Dec 16.