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

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A Correction to this article was published on 17 July 2019

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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.

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Change history

  • 17 July 2019

    The article Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy Delay Brain Metastasis in Patients with EGFR-Mutant Lung Adenocarcinom, written by Changhui Li, Bo Zhang, Jindong Guo, Fang Hu, Wei Nie, Xiaoxuan Zheng, Lixin Wang, Yuqing Lou, Yinchen Shen, Baohui Han, Xueyan Zhang, was originally published electronically on the publisher’s internet portal (currently SpringerLink) on 03 July 2019 with open access. With the author(s)’ decision to step back from Open Choice, the copyright of the article changed on 17 July 2019 to © Springer Nature Switzerland AG 2019 and the article is forthwith distributed under the terms of copyright.

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Acknowledgements

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

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Author notes

  1. Changhui Li and Bo Zhang contributed equally to this work.

Authors and Affiliations

  1. Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China

    Changhui Li, Bo Zhang, Fang Hu, Wei Nie, Xiaoxuan Zheng, Yuqing Lou, Yinchen Shen, Baohui Han & Xueyan Zhang

  2. Department of Radiation Oncology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, 200030, China

    Jindong Guo

  3. Integrated TCM and Western Medicine Department, Shanghai Pulmonary Hospital Affiliated to Tongji University, Shanghai, 200030, China

    Lixin Wang

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  1. Changhui Li
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Correspondence to Baohui Han or Xueyan Zhang.

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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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Li, C., Zhang, B., Guo, J. et al. Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy Delay Brain Metastasis in Patients with EGFR-Mutant Lung Adenocarcinoma. Targ Oncol 14, 423–431 (2019). https://doi.org/10.1007/s11523-019-00649-1

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