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Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching

BACKGROUND: Adjuvant therapy for stage IB non‐small cell lung cancer remains debatable. In this real‐world study, we evaluate the efficacy and safety of adjuvant epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) for resected stage IB lung adenocarcinoma. METHODS: This real‐worl...

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Autores principales: Shen, Leilei, Guo, Juntang, Zhang, Weidong, Zhang, Lianbin, Liu, Xi, Wang, Tao, Zhang, Tao, Liang, Chaoyang, Liu, Yang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557892/
https://www.ncbi.nlm.nih.gov/pubmed/37559419
http://dx.doi.org/10.1002/cam4.6443
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author Shen, Leilei
Guo, Juntang
Zhang, Weidong
Zhang, Lianbin
Liu, Xi
Wang, Tao
Zhang, Tao
Liang, Chaoyang
Liu, Yang
author_facet Shen, Leilei
Guo, Juntang
Zhang, Weidong
Zhang, Lianbin
Liu, Xi
Wang, Tao
Zhang, Tao
Liang, Chaoyang
Liu, Yang
author_sort Shen, Leilei
collection PubMed
description BACKGROUND: Adjuvant therapy for stage IB non‐small cell lung cancer remains debatable. In this real‐world study, we evaluate the efficacy and safety of adjuvant epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) for resected stage IB lung adenocarcinoma. METHODS: This real‐world study recruited 249 patients diagnosed with stage IB disease after surgical resection between January 2013 and September 2021. Sixty‐six (26.5%) patients received adjuvant targeted therapy (TKIs group), and 183 (73.5%) were enrolled in the clinical observation (CO) group. Propensity scores were matched to minimize the observed confounder effects between the two groups, and 59 patient pairs were matched. The primary endpoint was disease‐free survival (DFS). RESULTS: In the TKI group, 38 (64.4%) patients chose to receive icotinib, 27.1% (16/59) received gefitinib, and 5 patients (8.5%) chose osimertinib. The median follow‐up time was 30.8 months (range: 7–107 months). Two (3.4%) patients in the TKI group and 10 (16.9%) in the CO group experienced disease relapse. The 3‐year DFS rates were 98.3% in the TKI group and 83.0% in the CO group (HR: 0.10; 95% CI: 0.01–0.78; p = 0.008). DFS differences were found in the entire cohort (p = 0.005) and the matched cohort (p = 0.024) between the two groups. Multivariate analysis showed that adjuvant EGFR‐TKIs was an independent factor for DFS (HR: 0.211; 95% CI: 0.045–0.979; p = 0.047), along with poor cell differentiation (HR: 5.256; 95% CI: 1.648–16.769; p = 0.005), and spread through air spaces (HR: 5.612; 95% CI: 1.137–27.700; p = 0.034). None of the patients discontinued EGFR‐TKIs owing to the low occurrence rate of treatment‐related serious adverse events. CONCLUSION: Adjuvant EGFR‐TKIs could significantly improve DFS among patients with stage IB lung adenocarcinoma compared with CO, with a safe and tolerable profile.
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spelling pubmed-105578922023-10-07 Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching Shen, Leilei Guo, Juntang Zhang, Weidong Zhang, Lianbin Liu, Xi Wang, Tao Zhang, Tao Liang, Chaoyang Liu, Yang Cancer Med RESEARCH ARTICLES BACKGROUND: Adjuvant therapy for stage IB non‐small cell lung cancer remains debatable. In this real‐world study, we evaluate the efficacy and safety of adjuvant epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) for resected stage IB lung adenocarcinoma. METHODS: This real‐world study recruited 249 patients diagnosed with stage IB disease after surgical resection between January 2013 and September 2021. Sixty‐six (26.5%) patients received adjuvant targeted therapy (TKIs group), and 183 (73.5%) were enrolled in the clinical observation (CO) group. Propensity scores were matched to minimize the observed confounder effects between the two groups, and 59 patient pairs were matched. The primary endpoint was disease‐free survival (DFS). RESULTS: In the TKI group, 38 (64.4%) patients chose to receive icotinib, 27.1% (16/59) received gefitinib, and 5 patients (8.5%) chose osimertinib. The median follow‐up time was 30.8 months (range: 7–107 months). Two (3.4%) patients in the TKI group and 10 (16.9%) in the CO group experienced disease relapse. The 3‐year DFS rates were 98.3% in the TKI group and 83.0% in the CO group (HR: 0.10; 95% CI: 0.01–0.78; p = 0.008). DFS differences were found in the entire cohort (p = 0.005) and the matched cohort (p = 0.024) between the two groups. Multivariate analysis showed that adjuvant EGFR‐TKIs was an independent factor for DFS (HR: 0.211; 95% CI: 0.045–0.979; p = 0.047), along with poor cell differentiation (HR: 5.256; 95% CI: 1.648–16.769; p = 0.005), and spread through air spaces (HR: 5.612; 95% CI: 1.137–27.700; p = 0.034). None of the patients discontinued EGFR‐TKIs owing to the low occurrence rate of treatment‐related serious adverse events. CONCLUSION: Adjuvant EGFR‐TKIs could significantly improve DFS among patients with stage IB lung adenocarcinoma compared with CO, with a safe and tolerable profile. John Wiley and Sons Inc. 2023-08-09 /pmc/articles/PMC10557892/ /pubmed/37559419 http://dx.doi.org/10.1002/cam4.6443 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Shen, Leilei
Guo, Juntang
Zhang, Weidong
Zhang, Lianbin
Liu, Xi
Wang, Tao
Zhang, Tao
Liang, Chaoyang
Liu, Yang
Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title_full Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title_fullStr Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title_full_unstemmed Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title_short Clinical efficacy and safety of adjuvant EGFR‐TKIs for resected stage IB lung adenocarcinoma: A real‐world study based on propensity score matching
title_sort clinical efficacy and safety of adjuvant egfr‐tkis for resected stage ib lung adenocarcinoma: a real‐world study based on propensity score matching
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557892/
https://www.ncbi.nlm.nih.gov/pubmed/37559419
http://dx.doi.org/10.1002/cam4.6443
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