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. 2016 Nov 8;16(1):868.
doi: 10.1186/s12885-016-2917-6.

Impact of clinical parameters and systemic inflammatory status on epidermal growth factor receptor-mutant non-small cell lung cancer patients readministration with epidermal growth factor receptor tyrosine kinase inhibitors

Yu-Mu Chen  1 , Chien-Hao Lai  1 , Kun-Ming Rau  2 , Cheng-Hua Huang  2 , Huang-Chih Chang  1 , Tung-Ying Chao  1 , Chia-Cheng Tseng  1 , Wen-Feng Fang  1   3 , Yu-Hsiu Chung  1 , Yi-Hsi Wang  1 , Mao-Chang Su  1 , Kuo-Tung Huang  1 , Shih-Feng Liu  1 , Hung-Chen Chen  1 , Ya-Chun Chang  1 , Yu-Ping Chang  1 , Chin-Chou Wang  1 , Meng-Chih Lin  4
Affiliations

Impact of clinical parameters and systemic inflammatory status on epidermal growth factor receptor-mutant non-small cell lung cancer patients readministration with epidermal growth factor receptor tyrosine kinase inhibitors

Yu-Mu Chen et al. BMC Cancer. .

Abstract

Background: Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) readministration to lung cancer patients is common owing to the few options available. Impact of clinical factors on prognosis of EGFR-mutant non-small cell lung cancer (NSCLC) patients receiving EGFR-TKI readministration after first-line EGFR-TKI failure and a period of TKI holiday remains unclear. Through this retrospective study, we aimed to understand the impact of clinical factors in such patients.

Methods: Of 1386 cases diagnosed between December 2010 and December 2013, 80 EGFR-mutant NSCLC patients who were readministered TKIs after failure of first-line TKIs and intercalated with at least one cycle of cytotoxic agent were included. We evaluated clinical factors that may influence prognosis of TKI readministration as well as systemic inflammatory status in terms of neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR). Baseline NLR and LMR were estimated at the beginning of TKI readministration and trends of NLR and LMR were change amount from patients receiving first-Line TKIs to TKIs readministration.

Results: Median survival time since TKI readministration was 7.0 months. In the univariable analysis, progression free survival (PFS) of first-line TKIs, baseline NLR and LMR, and trend of LMR were prognostic factors in patients receiving TKIs readministration. In the multivariate analysis, only PFS of first-line TKIs (p < 0.001), baseline NLR (p = 0.037), and trend of LMR (p = 0.004) were prognostic factors.

Conclusion: Longer PFS of first-line TKIs, low baseline NLR, and high trend of LMR were good prognostic factors in EGFR-mutant NSCLC patients receiving TKI readministration.

Keywords: Epidermal growth factor receptor; Lymphocyte-to-monocyte ratio; Neutrophil-to-lymphocyte ratio; Non-small cell lung cancer; Readministration; Tyrosine kinase inhibitor.

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Figures

Fig. 1
Fig. 1
Inclusion, screening, and assignment of patients into groups
Fig. 2
Fig. 2
Overall survival since the readministration of tyrosine kinase inhibitors of patients with short (<6 months), intermediate (6–12 months), and long (>12 months) progression free survival of first-line tyrosine kinase inhibitors
Fig. 3
Fig. 3
Influence of baseline proinflammatory markers on overall survival (OS) of patients who were readministered with tyrosine kinase inhibitors (a) OS between patients with high and low baseline neutrophil-to-lymphocyte ratio (NLR); (b) OS between patients with high and low lymphocyte-to-monocyte ratio (LMR)
Fig. 4
Fig. 4
Influence of trends of lymphocyte-to-monocyte ratio (LMR) on overall survival (OS) of patients who were readministered with tyrosine kinase inhibitors OS between patients with high and low trend of LMR
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