First-Line EGFR-TKIs Treatment in Stage I Non-Small-Cell Lung Cancer Patients Harboring EGFR Gene Mutations with Postoperative Intrapulmonary Recurrence

Abstract

Background

The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is an effective treatment for advanced lung cancer harboring EGFR gene mutations, and has improved progression-free survival in several clinical trials.

Methods

We investigated 30 stage I non-small-cell lung cancer patients harboring EGFR gene mutations with postoperative intrapulmonary recurrence. Progression-free survival and response rate were analyzed.

Results

Partial response was achieved in 23 patients and stable disease was found in 7 patients. The objective response rate was 76.7% and disease control rate was 100%. The median progression-free survival (PFS) time was 24.5 months. The median PFS in patients with only intrapulmonary recurrence was significantly superior to patients with both intrapulmonary recurrence and metastasis (32.0 months vs 14.0 months, P = 0.003). The median PFS observed in patients who underwent icotinib treatment was significantly longer than in patients who underwent gefitinib treatment (30.5 months vs 12.0 months, p = 0.005). There were no statistical differences in median PFS between patients with tumors harboring exon 21 mutation and exon 19 deletion, age <65 and ≥65, male and female, smoker and non-smoker.

Conclusion

Our result reveals that first-line EGFR-TKIs treatment for stage I non-small-cell lung cancer patients harboring EGFR gene mutations with postoperative intrapulmonary recurrence is effective and could be a useful option in practical setting.

Keywords:

• EGFR-TKIs
• lung cancer
• postoperative recurrence
• stage I
• efficacy

Acknowledgments

This work was supported by grants from the Science and Technology Department of Zhejiang Province (2013c03044-7, YC), Natural Science Foundation of Zhejiang Province (LY13H160016, YC), and Wu Jieping Medical Foundation (320.6799.15040).

Abbreviations

EGFR, epidermal growth factor receptor; TKI, tyrosine kinase inhibitor; NSCLC, non-small cell lung cancer; SCLC, small cell lung cancer; PFS, progression-free survival; PD, progressive disease; DCR, disease control rate; CR, complete response; PR, partial response; SD, stable disease; ORR, objective response rate.

Disclosure

The authors report no conflict of interest in this work.