RT Journal Article
SR Electronic
T1 EGFR tyrosine kinase inhibitors versus chemotherapy in EGFR wild-type pre-treated advanced nonsmall cell lung cancer in daily practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1700514
DO 10.1183/13993003.00514-2017
VO 50
IS 2
A1 Pascale Tomasini
A1 Solenn Brosseau
A1 Julien Mazières
A1 Jean-Philippe Merlio
A1 Michèle Beau-Faller
A1 Jean Mosser
A1 Marie Wislez
A1 L'Houcine Ouafik
A1 Benjamin Besse
A1 Isabelle Rouquette
A1 Didier Debieuvre
A1 Fabienne Escande
A1 Virginie Westeel
A1 Clarisse Audigier-Valette
A1 Pascale Missy
A1 Alexandra Langlais
A1 Frank Morin
A1 Denis Moro-Sibilot
A1 Gérard Zalcman
A1 Fabrice Barlesi
YR 2017
UL http://erj.ersjournals.com/content/50/2/1700514.abstract
AB Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are approved for second-line treatment of EGFR wild-type (EGFR-wt) nonsmall cell lung cancer (NSCLC). However, results from randomised trials performed to compare EGFR-TKIs with chemotherapy in this population did not show any survival benefit. In the era of immunotherapy, many drugs are approved for second-line treatment of EGFR-wt NSCLC and there is a need to reassess the role of EGFR-TKIs in this setting.The Biomarkers France study is a large nationwide cohort of NSCLC patients tested for EGFR mutations. We used this database to collect clinical, biological, treatment and outcome data on EGFR-wt patients who received second-line treatment with either EGFR-TKIs or chemotherapy.Among 1278 patients, 868 received chemotherapy and 410 received an EGFR-TKI. Median overall survival and progression-free survival were longer with chemotherapy than with an EGFR-TKI. Overall survival was 8.38 versus 4.99 months, respectively (hazard ratio 0.70, 95% CI 0.59–0.83; p<0.0001) and progression-free survival was 4.30 versus 2.83 months, respectively (hazard ratio 0.66, 95% CI 0.57–0.77; p<0.0001).This study is helpful to guide a multiline treatment strategy for EGFR-wt NSCLC patients. Immunotherapy is approved for second-line treatment. For third-line treatment, chemotherapy results in longer overall survival and progression-free survival, and should be preferred to EGFR-TKIs.Biomarkers France study: second-line chemotherapy gave longer PFS and OS than TKI in NSCLC EGFR-wt patients http://ow.ly/rEXk30b3tak