| Real-world treatment outcomes in South Korean patients with epidermal growth factor receptor-mutant non-small cell lung cancer |
Young Saing Kim1, Eun Young Lee2, Hyun Woo Lee3
, Jin-Hyuk Choi3, Tae-Hwan Kim3, Yong Won Choi3, and Mi Sun Ahn3 |
1Division of Medical Oncology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
2Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, USA
3Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea |
Corresponding Author:
Hyun Woo Lee , Tel: +82-31-219-5989, Fax: +82-31-219-5983, Email: hwlee71@gmail.com
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Received: February 12, 2024; Revised: October 17, 2024; Accepted: March 18, 2025. |
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| Abstract |
Background/Aims: This study aimed to assess the real-world treatment outcomes in South Korean patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) receiving first-line (1L) EGFR tyrosine kinase inhibitors (TKIs).
Methods: We used the Health Insurance Review and Assessment Service database, which includes the data of a large proportion of the Korean population. Patients with EGFR-positive NSCLC who received gefitinib, erlotinib, or afatinib as the 1L treatment between 2012 and 2018 were included. Survival outcomes, subsequent therapies, and treatment patterns were analyzed.
Results: Among the 9,478 patients included, gefitinib (56.68%) was the most commonly prescribed 1L EGFR-TKI, followed by afatinib (25.30%) and erlotinib (18.02%). The median time to next treatment was 16.4 to 18.8 months. Overall survival (OS) was significantly different among the three treatment groups; the median OS was 28.8, 25.3, and 23.9 months for patients who were treated with afatinib, gefitinib, and erlotinib, respectively (p < 0.001). For the patients who received second-line (2L) therapy (n = 4,904, 51.74%), pemetrexed monotherapy was most commonly used (47.70%), followed by osimertinib (21.59%). Patients who received osimertinib as the 2L treatment had longer OS compared to those receiving pemetrexed (median OS: not reached vs. 25.3 to 28.8 months).
Conclusions: Our real-world study demonstrated survival outcomes that were comparable to those observed in clinical trials for patients with EGFR-mutant NSCLC treated with EGFR-TKIs. Detection of the acquired T790M mutation and subsequent osimertinib treatment had significant prognostic value. |
| Keywords:
Non-small cell lung cancer ; Epidermal growth factor receptor ; Tyrosine kinase inhibitors ; Real-world ; Survival |
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