Baseline anemia predicts a poor prognosis in patients with non-small cell lung cancer with epidermal growth factor receptor mutations: a retrospective study

Abstract

Background Anemia is relatively common in cancer patients, and baseline anemia is associated with poor survival in patients with non-small cell lung cancer (NSCLC). However, there is a lack of large-sample studies of patients with NSCLC with epidermal growth factor receptor (EGFR) mutations. Methods We retrospectively analyzed anemia‑related data for patients with NSCLC and EGFR mutations who were admitted to Zhejiang Cancer Hospital from January 2013 to June 2019 and treated with targeted therapy. The patients’ clinicopathological features were evaluated by χ2 tests and the relationships between clinical characteristics and prognosis were investigated using Kaplan–Meier and multivariate Cox regression analyses. Results A total of 2,029 patients treated with EGFR-tyrosine kinase inhibitors (TKIs) were finally enrolled in this study, of whom 24.6% had baseline anemia. Patients without baseline anemia had longer median overall survival (OS) than patients with baseline anemia (36.10 vs. 29.10 months, P = 0.001), and patients with grade < 2 anemia had longer median OS than those with grade ≥ 2 anemia (35.00 vs. 25.10 months, P < 0.001). Multivariate analyses identified baseline anemia as a factor predicting a poor prognosis in terms of OS in patients with EGFR mutations. Conclusions Baseline anemia is a significant factor predicting a poor prognosis in terms of OS in patients with NSCLC and EGFR mutations treated with targeted therapy. A higher grade of baseline anemia may also be related to shorter OS. And a higher risk of EGFR-mutated patients who had received targeted therapy could also be observed.

Identification of predictive factors for early relapse in patients with unresectable stage III non‐small cell lung cancer receiving consolidation durvalumab after concurrent chemoradiation therapy

“…14,15 Also, anemia predicts a poor prognosis in advanced lung cancer. 16,17 In our study, mean values of pack years, PD-L1 (SP263) expression, NLR and LDH were significantly different between early and non-early relapse groups. Also, the proportion of COPD and the mean value of hemoglobin level tended to be higher in the non-early relapse group.…”

“…Smoking, age, ECOG PS and TNM staging are widely recognized as the prognostic factors for lung cancer 14,15 . Also, anemia predicts a poor prognosis in advanced lung cancer 16,17 . In our study, mean values of pack years, PD‐L1(SP263) expression, NLR and LDH were significantly different between early and non‐early relapse groups.…”

Neoadjuvant chemotherapy-induced hemoglobin decline as a prognostic factor in osteosarcoma around the knee joint: a single-center retrospective analysis of 242 patients

“…Several studies have confirmed that Hb concentrations might be a valuable prognostic indicator for prognosis in various cancers [ 26 – 29 ]. In OS, this predictive value of Hb concentrations in survival was still controversial [ 14 ].…”

Pulmonary hypertension is common among patients with advanced lung cancer and Khorana score is the predictive indicator

“…Even among those harboring EGFR mutation in particular, patients with anemia of grade 2 or better had independently longer median OS. 27 Advanced cancer is a systemic in ammatory disease. Its biologic effects, especially through cytokine interference related to high tumor burden would affect the red blood cell production.…”