Background: Epidermal growth factor (EGFR) gene mutation status in lung adenocarcinoma has been demonstrated to reflect the therapeutic efficacy of tyrosine kinase inhibitors (TKIs). In this study, we investigated the association of EGFR mutation status with prognostic impact. Method: From January 2010 to December 2018, we retrospectively reviewed 450 patients with resected lung adenocarcinomas who underwent EGFR mutation status analysis. Clinicopathological factors analyzed included age, sex/gender, smoking history, serum carcinoembryonic antigen (CEA) levels, lymphatic invasion (Ly), vascular invasion (V), histological grade, malignant component, pathological stage, and EGFR mutation. Univariate and multivariate analyses of overall survival (OS) and recurrence-free survival (RFS) were conducted. Result: The study group comprised 450 patients (260 men, 190 women; age range: 32e88 years; mean age: 67.6±9.9 years). The median follow-up period was 35.4 months. A total of 282 patients were smokers and 168 were nonsmokers. EGFR mutation analysis identified 186 patients with EGFR mutation and 264 patients with wild-type EGFR. Preoperative CEA was elevated in 117 patients. Ly, V, high grade, high malignant component and advanced stage were observed in 72, 73, 209, 120 and 102 patients, respectively. The 5-year OS in patients with EGFR mutation was 80.6% compared with 75.6% for those with wild-type EGFR (p¼0.011). The 5-year RFS in patients with EGFR mutation status was 77.1% compared with 66.8% for patients with wild-type EGFR (p¼0.036). There were no significant differences in OS and RFS between patients with exon 21 L858R, exon 19 deletion and other mutation subtypes. In addition, there was no survival difference in patients with EGFR mutation who received TKI or not after lung cancer recurrence. In multivariate analysis for OS, EGFR mutation status was an independent significant prognostic factor, as well as age, Ly, and pathological stage. Conclusion: EGFR mutation status is an independent good prognostic factor in patients with resected lung adenocarcinoma regardless of TKI use. EGFR mutation subtypes did not show significant differences in prognosis.
Introduction: Anlotinib is an oral receptor tyrosine kinase (RTK) inhibitor and targets multiple RTKs including VEGFR, PDGFR, FGFR, EGFR and c-kit. Anlotinib monotherapy was approved in China as a subsequent therapy for advanced NSCLC patients who progressed after at least 2 lines of prior systemic therapies. This study evaluated clinical outcomes and safety of anlotinib for patients with advanced lung squamous cell carcinoma (lung SCC) in real world practice. Methods: The medical data of patients with advanced lung SCC who were treated with anlotinib at Yantai Yuhuangding Hospital between June 2018 and December 2019 was retrospectively collected. Progression-free survival (PFS) and overall survival (OS) were estimated using the KaplaneMeier method. Results: One hundred and seven patients were included in the analysis, of whom 74 (69.2%) were male and 33 (30.8%) were female, with a median age of 65 years. The median PFS was 5.0 months. The median OS was 12.3 months. Subgroup analysis revealed that significant improved outcomes were noted only for patients aged 70 years and those with ECOG PS 0/1. Partial response (PR) were recorded in 12 patients (11.2%), stable disease (SD) in 76 patients (71%), and progressive disease (PD) in 19 patients (17.8%). The objective response rate (ORR) was 11.2% and the disease control rate (DCR) was 82.2%. Conclusion: In the real world setting, anlotinib monotherapy showed favorable efficacy and safety for advanced lung SCC as a third line or beyond treatment.
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