Survival analysis of patients with advanced non‐small cell lung cancer receiving tyrosine kinase inhibitor (TKI) treatment: A multi‐center retrospective study

BACKGROUND: The study was conducted to assess differences in overall survival (OS) in patients with non‐small cell lung cancer (NSCLC) receiving different treatment modalities of tyrosine kinase inhibitors (TKIs). METHODS: A total of 463 NSCLC patients receiving TKI treatment were included. OS was compared according to treatment timing in all patients, the elderly, and patients positive for EGFR mutations. RESULTS: One hundred and seventy two patients received TKIs as first‐line treatment, 220 as second‐line, and 67 as third‐line. The results between the three groups were not statistically significant: the one, two, and three‐year OS rates were: 55.3%, 22.3%, and 11.3% (first‐line); 59.6%, 27.8%, and 14.9% (second‐line); and 53.8%, 41.3%, and 29.5% (third‐line), respectively (P = 0.095). Results between the three groups of elderly patients were also not statistically significant (P = 0.469). The one and two‐year OS rates in EGFR mutation‐positive patients receiving first‐line treatment were 48% and 17.5%, respectively. The one, two, and three‐year OS rates of patients receiving second‐line treatment were: 54.2%, 30.3%, and 20.2%, respectively. There were no statistically significant differences between the groups with EGFR mutations receiving first‐line or second‐line treatment. Thirteen EGFR mutation‐positive patients received third‐line TKI treatment for a median duration of 7 months. Their one and two‐year OS rates were 69.8% and 58.2%, respectively, which were higher than in the other two groups (P = 0.015). CONCLUSION: Three lines of TKI therapy can prolong survival in NSCLC patients. Elderly patients can benefit from TKI therapy. EGFR mutation‐positive patients can benefit from second‐line or third‐line TKI therapy.