OUTCOMES OF FIRSTLINE TREATMENT WITH FIRST GENERATION EGFR-TKIS IN NON-SMALL CELL LUNG CANCER PATIENTS AT HUU NGHI HOSPITAL

Thị Thanh Hoa Nguyễn1,, Lê Huy Trịnh2, Chí Hiếu Lê1
1 Huu Nghi hospital
2 HMU

Main Article Content

Abstract

Objectives: Describe some clinical and laboratory characteristics of NCSLC patients with positive EGFR mutation who treated with first generation TKIs at Huu Nghi Hospital. Evaluation of treatment results and some undesirable effects of the study group of patients. Subjects and research methods: Retrospective study of 67 patients diagnosed with stage IIIB-IV NSCLC treated with first generation TKIs (Gefitinib or Erlotinib) at Huu Nghi Hospital from June 2015 to May 2023. Results: Most of the patients in the study were elderly with an average age of 73.6, the highest was 88. The ratio of men was higher than that of women (2.7/1). The most common first symptoms are a persistent cough, fatigue, and chest pain. Patients are mainly diagnosed with stage IV disease. Tumor location is common in the upper lobes of the two lungs (56.7%), most of the tumor cells belong to the adenocarcinoma group (97%). EGFR gene mutations were most common in exon 19 (58.2%). Response to treatment with 1st generation TKIs in the study group of patients after 3 months: overall response rate: 73.1%, disease control rate: 95.5%. Clinical symptoms improve after 2 to 4 weeks and further decrease with the duration of dosing. Common side effects are: nail inflammation, fatigue, increased liver enzymes, acne-like rash, usually of a mild degree, the rate of moderate-severe side effects requiring dose reduction or drug change is quite low. Conclusion: Treatment of 1st generation TKIs for NSCLC patients with EGFR mutation has good results and toxicity is within acceptable limits.

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References

GLOBOCAN 2020. http://globocan.iarc. fr/old/ bar_sex_pop.asp?selection=213704&title=Viet+Nam&statistic=1&number=20&window=1&grid=1&info=1&color1=5&color1e=&color2=4&color2e=&submit=%C2%A0Execute%C2%A0
2. Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma. N Engl J Med. 2009; 361(10):947-957. doi:10.1056/NEJMoa0810699
3. Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011;12(8):735-742. doi:10.1016/S1470-2045(11)70184-X
4. Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012;13(3): 239-246. doi: 10.1016/ S1470-2045(11) 70393-X
5. Kobayashi S, Boggon TJ, Dayaram T, et al. EGFR Mutation and Resistance of Non–Small-Cell Lung Cancer to Gefitinib. N Engl J Med. 2005; 352(8): 786-792. doi: 10.1056/ NEJMoa044238
6. Hiếu NV, Đại LC, Quảng LV. Ung Thư Học. Nhà xuất bản Y học; 2015.
7. Porta R, Sánchez-Torres JM, Paz-Ares L, et al. Brain metastases from lung cancer responding to erlotinib: the importance of EGFR mutation. Eur Respir J. 2011; 37(3): 624-631. doi: 10.1183/ 09031936. 00195609
8. Wu YL, Zhou C, Cheng Y, et al. Erlotinib as second-line treatment in patients with advanced non-small-cell lung cancer and asymptomatic brain metastases: a phase II study (CTONG-0803). Ann Oncol Off J Eur Soc Med Oncol. 2013;24(4):993-999. doi:10.1093/annonc/mds529