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Impact of second-line treatment on overall survival of advanced lung adenocarcinoma patients

Chai Chee Shee, Liam Chong Kin, Pang Yong Kek, Kow Keng Siong, Poh Mau Ern, Wong Chee Kuan, Tan Jiunn Liang
European Respiratory Journal 2016 48: PA4840; DOI: 10.1183/13993003.congress-2016.PA4840
Chai Chee Shee
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Liam Chong Kin
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Pang Yong Kek
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Kow Keng Siong
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Poh Mau Ern
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Wong Chee Kuan
2Department of Medicine, University Malaysia Sarawak, Kota Samarahan, SarawakMalaysia
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Tan Jiunn Liang
1Department of Medicine, University Malaya Medical Center, Kuala Lumpur, Malaysia
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Abstract

Background Randomised control trials (RCTs) show good overall survival (OS) for advanced lung adenocarcinoma patients is much dependent on subsequent-line of treatment upon disease progression on first-line treatment. However, not many studies look into such outcome in real-world setting.

Aims To determine the impact of second-line treatment on OS for advanced lung adenocarcinoma patients who failed first-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) or chemotherapy in the real world-setting.

Methods A retrospective analysis of advanced lung adenocarcinoma patients who developed disease progression on first-line EGFR-TKI or chemotherapy treatmentat the University of Malaya Medical Centre from 1st August 2010 to 31th July 2014.

Results Of 78 patients with EGFR mutant tumours and failed first-line EGFR-TKI, 23 patients (29.5%) received second-line chemotherapy while remaining 56 patients (70.5%) had best supportive care (BSC). Subgroup analysis showed that patients who received second-line chemotherapy had numerically better median OS (12.60 months) than those received BSC (9.03 months) (HR, 0.53; 95% CI, 0.24-1.21; p=0.134).

Of 79 patients with EGFR wild-type tumours and failed first-line chemotherapy, 36 patients (45.6%) received second-line chemotherapy and 43 patients (54.4%) had BSC - the median OS for the former was 11.50 months and the latter was 5.47 months (HR, 0.58; 95% CI, 0.34-0.98; p=0.043).

Conclusions In the real-world setting, second-line active treatment significantly prolonged the OS. The OS in this study was shorter than that in RCTS due to presence of co-morbidities, poorer ECOG performance at diagnosis and lower rate of second-line treatment.

  • Lung cancer / Oncology
  • Thoracic oncology
  • Molecular pathology
  • Copyright ©the authors 2016
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Impact of second-line treatment on overall survival of advanced lung adenocarcinoma patients
Chai Chee Shee, Liam Chong Kin, Pang Yong Kek, Kow Keng Siong, Poh Mau Ern, Wong Chee Kuan, Tan Jiunn Liang
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4840; DOI: 10.1183/13993003.congress-2016.PA4840

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Impact of second-line treatment on overall survival of advanced lung adenocarcinoma patients
Chai Chee Shee, Liam Chong Kin, Pang Yong Kek, Kow Keng Siong, Poh Mau Ern, Wong Chee Kuan, Tan Jiunn Liang
European Respiratory Journal Sep 2016, 48 (suppl 60) PA4840; DOI: 10.1183/13993003.congress-2016.PA4840
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