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Targeted Oncology

, Volume 14, Issue 4, pp 423–431 | Cite as

Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy Delay Brain Metastasis in Patients with EGFR-Mutant Lung Adenocarcinoma

  • Changhui Li
  • Bo Zhang
  • Jindong Guo
  • Fang Hu
  • Wei Nie
  • Xiaoxuan Zheng
  • Lixin Wang
  • Yuqing Lou
  • Yinchen Shen
  • Baohui HanEmail author
  • Xueyan ZhangEmail author
Original Research Article

Abstract

Background

Whether epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) combined with chemotherapy can delay the occurrence of brain metastasis (BM) is unclear.

Objective

This retrospective study aimed to evaluate whether EGFR–TKIs combined with chemotherapy can delay BM and decrease the incidence of BM as initial progression.

Patients and Methods

The data of 100 patients with EGFR-mutant advanced lung adenocarcinoma were retrospectively reviewed. The patients had no BM at initial diagnosis, and BM occurred during the treatment. Patients received EGFR–TKI only or EGFR–TKI combined with chemotherapy. Intracranial progression-free survival (iPFS), systemic progression-free survival (PFS), and overall survival (OS) were evaluated.

Results

The overall median OS was 39 months (95% confidence interval (CI), 35.6–42.4 months). The median OS of EGFR–TKI combined with chemotherapy and EGFR–TKI only are 41 months (95% CI 35.5–46.5 months) and 39 months (95% CI 36.8–41.2 months), respectively. Patients in the combination treatment group had longer PFS (16 vs. 10 months; P = 0.030) and iPFS (21 vs. 14 months; P = 0.026). Further, as initial progression, fewer patients developed BM in the combined treatment group compared with the EGFR–TKI-only group (30.6% vs. 52.9%, P = 0.002) with a hazard ratio of 0.64 (95% CI 0.43–0.96). After controlling for significant covariables in a multivariable model, the different treatment strategies were independently associated with improved iPFS.

Conclusions

In this retrospective analysis, EGFR–TKIs combined with chemotherapy could improve PFS. Further, the combined treatment could delay BM occurrence and decrease the incidence of BM as initial progression.

Notes

Acknowledgements

The authors greatly appreciate all patients who contributed to this study.

Compliance with Ethical Standards

Funding

This study was funded by the Science and Technology Commission of Shanghai Municipality, China (No.18441904700), and the nurture projects for basic research of Shanghai Chest Hospital (No. 2018YNJCM05).

Conflict of interest

Changhui Li, Bo Zhang, Jindong Guo, Fang Hu, Wei Nie, Xiaoxuan Zheng, Lixin Wang, Yuqing Lou, Yinchen Shen, Baohui Han, and Xueyan Zhang declare that they have no conflicts of interest that might be relevant to the content of this article.

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Copyright information

© The Author(s) 2019
corrected publication 2019

Authors and Affiliations

  1. 1.Department of Pulmonary Medicine, Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina
  2. 2.Department of Radiation Oncology, Shanghai Chest HospitalShanghai Jiao Tong UniversityShanghaiChina
  3. 3.Integrated TCM and Western Medicine DepartmentShanghai Pulmonary Hospital Affiliated to Tongji UniversityShanghaiChina

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