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.
- Copyright ©the authors 2016
