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Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma

Background: Recent studies have demonstrated benefits from adjuvant tyrosine-kinase inhibitors (TKIs) compared with chemotherapy in non-small cell lung cancer. We launched a multi-center retrospective study to evaluate the efficacy and toxicity of adjuvant TKIs with or without chemotherapy in epider...

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Autores principales: Li, Qiwen, Ma, Li, Qiu, Bo, Wen, Yuzhi, Liang, Wenhua, Hu, Wanming, Chen, Naibin, Zhang, Tian, Xu, Shuangbing, Chen, Lingjuan, Guo, Minzhang, Zhao, Yi, Liu, Songran, Guo, Jinyu, Wang, Junye, Wang, Siyu, Wang, Xin, Pang, Qingsong, Long, Hao, Liu, Hui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167779/
https://www.ncbi.nlm.nih.gov/pubmed/33916930
http://dx.doi.org/10.3390/curroncol28020135
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author Li, Qiwen
Ma, Li
Qiu, Bo
Wen, Yuzhi
Liang, Wenhua
Hu, Wanming
Chen, Naibin
Zhang, Tian
Xu, Shuangbing
Chen, Lingjuan
Guo, Minzhang
Zhao, Yi
Liu, Songran
Guo, Jinyu
Wang, Junye
Wang, Siyu
Wang, Xin
Pang, Qingsong
Long, Hao
Liu, Hui
author_facet Li, Qiwen
Ma, Li
Qiu, Bo
Wen, Yuzhi
Liang, Wenhua
Hu, Wanming
Chen, Naibin
Zhang, Tian
Xu, Shuangbing
Chen, Lingjuan
Guo, Minzhang
Zhao, Yi
Liu, Songran
Guo, Jinyu
Wang, Junye
Wang, Siyu
Wang, Xin
Pang, Qingsong
Long, Hao
Liu, Hui
author_sort Li, Qiwen
collection PubMed
description Background: Recent studies have demonstrated benefits from adjuvant tyrosine-kinase inhibitors (TKIs) compared with chemotherapy in non-small cell lung cancer. We launched a multi-center retrospective study to evaluate the efficacy and toxicity of adjuvant TKIs with or without chemotherapy in epidermal growth factor receptor (EGFR)-mutant stage III-pN2 lung adenocarcinoma. Methods: Two hundred and seventy-four consecutive cases with stage III-pN2 lung adenocarcinoma and complete resection have been investigated. Clinic-pathologic characteristics, adjuvant treatments, long-term survivals, and toxicities were documented. Risk factors of distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated. Results: There were 52 (19.0%) patients treated with adjuvant TKIs alone, 199 (72.6%) with adjuvant chemotherapy alone, and 23 (8.4%) with both. After a median follow-up time of 29 months, the two-year DMFS, DFS, and OS was 61.2%, 54.1%, and 91.2%, respectively. According to univariable analyses, the risk factors were lymphovascular invasion (p < 0.001), extranodal extension (p = 0.005), and adjuvant systemic therapy (p = 0.006) for DMFS, EGFR mutation type (p = 0.025), lymphovascular invasion (p = 0.013), extranodal extension (p = 0.004), and adjuvant systemic therapy (p < 0.001) for DFS, and EGFR mutation type (p < 0.001) for OS. Multivariable analyses indicated that the independent prognostic factors were adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, Harzard ratio (HR) = 0.40; p = 0.036; TKIs vs. chemotherapy, HR = 0.38; p = 0.004), lymphovascular invasion (yes vs. no, HR = 2.22; p = 0.001) for DMFS, and adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, HR = 0.42; p = 0.034; TKIs vs. chemotherapy, HR = 0.33; p < 0.001) for DFS. No significant difference was found in the incidence of Grade 3–4 toxicities between groups (p = 0.445). Conclusions: Adjuvant TKIs might be a beneficial choice compared with adjuvant chemotherapy or combination systemic treatments.
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spelling pubmed-81677792021-06-02 Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma Li, Qiwen Ma, Li Qiu, Bo Wen, Yuzhi Liang, Wenhua Hu, Wanming Chen, Naibin Zhang, Tian Xu, Shuangbing Chen, Lingjuan Guo, Minzhang Zhao, Yi Liu, Songran Guo, Jinyu Wang, Junye Wang, Siyu Wang, Xin Pang, Qingsong Long, Hao Liu, Hui Curr Oncol Article Background: Recent studies have demonstrated benefits from adjuvant tyrosine-kinase inhibitors (TKIs) compared with chemotherapy in non-small cell lung cancer. We launched a multi-center retrospective study to evaluate the efficacy and toxicity of adjuvant TKIs with or without chemotherapy in epidermal growth factor receptor (EGFR)-mutant stage III-pN2 lung adenocarcinoma. Methods: Two hundred and seventy-four consecutive cases with stage III-pN2 lung adenocarcinoma and complete resection have been investigated. Clinic-pathologic characteristics, adjuvant treatments, long-term survivals, and toxicities were documented. Risk factors of distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated. Results: There were 52 (19.0%) patients treated with adjuvant TKIs alone, 199 (72.6%) with adjuvant chemotherapy alone, and 23 (8.4%) with both. After a median follow-up time of 29 months, the two-year DMFS, DFS, and OS was 61.2%, 54.1%, and 91.2%, respectively. According to univariable analyses, the risk factors were lymphovascular invasion (p < 0.001), extranodal extension (p = 0.005), and adjuvant systemic therapy (p = 0.006) for DMFS, EGFR mutation type (p = 0.025), lymphovascular invasion (p = 0.013), extranodal extension (p = 0.004), and adjuvant systemic therapy (p < 0.001) for DFS, and EGFR mutation type (p < 0.001) for OS. Multivariable analyses indicated that the independent prognostic factors were adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, Harzard ratio (HR) = 0.40; p = 0.036; TKIs vs. chemotherapy, HR = 0.38; p = 0.004), lymphovascular invasion (yes vs. no, HR = 2.22; p = 0.001) for DMFS, and adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, HR = 0.42; p = 0.034; TKIs vs. chemotherapy, HR = 0.33; p < 0.001) for DFS. No significant difference was found in the incidence of Grade 3–4 toxicities between groups (p = 0.445). Conclusions: Adjuvant TKIs might be a beneficial choice compared with adjuvant chemotherapy or combination systemic treatments. MDPI 2021-04-07 /pmc/articles/PMC8167779/ /pubmed/33916930 http://dx.doi.org/10.3390/curroncol28020135 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Li, Qiwen
Ma, Li
Qiu, Bo
Wen, Yuzhi
Liang, Wenhua
Hu, Wanming
Chen, Naibin
Zhang, Tian
Xu, Shuangbing
Chen, Lingjuan
Guo, Minzhang
Zhao, Yi
Liu, Songran
Guo, Jinyu
Wang, Junye
Wang, Siyu
Wang, Xin
Pang, Qingsong
Long, Hao
Liu, Hui
Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title_full Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title_fullStr Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title_full_unstemmed Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title_short Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
title_sort benefit from adjuvant tkis versus tkis plus chemotherapy in egfr-mutant stage iii-pn2 lung adenocarcinoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167779/
https://www.ncbi.nlm.nih.gov/pubmed/33916930
http://dx.doi.org/10.3390/curroncol28020135
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