Pre-treatment Neutrophil-to-Lymphocyte Ratio significantly affects progression free survival in positive EGFR mutation advanced lung adenocarcinoma with EGFR-TKI treatment in Bali, Indonesia.
Ni Putu Ayu Widiasari, Ida Bagus Ngurah Rai, Ida Ayu Jasminarti Dk, I Gede Ketut Sajinadiyasa, Ni Wayan Candrawati, Ni Luh Putu Eka Arisanti
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引用次数: 0
Abstract
Introduction: Today, recommendations about initial Response Evaluation Criteria in Solid Tumor (RECIST) and its frequency still vary, while early diagnosis of progression affects patient's prognosis and subsequent treatment options. Methods: This study aims to examine Progression Free Survival (PFS) of positive EGFR mutations advanced lung adenocarcinoma receiving Tyrosine Kinase Inhibitor (TKI) and factors that influence it. This was an observational study with retrospective cohort design conducted at Prof IGNG Ngoerah Hospital from January to December 2021. Sample was data from Epidermal Growth Factor Receptor (EGFR) positive mutation advanced lung adenocarcinoma patient who were treated with EGFR-TKI at Prof IGNG Ngoerah Hospital, Denpasar, Bali from January 2017 to February 2021. Total sample was 63. Results: Median PFS was 12 months (95% CI 10.28-13.71) and minimum PFS was 3 months. In univariate analysis, Hazard Ration (HR) of older age, smoker, distant metastasis, brain metastasis, increased Neutrophil-to-Lymphocyte Ration (NLR), and exon 21 mutation to shorter PFS was 0.99 (95% CI 0.95-1.02); 1.03 (95% CI 0.57-1.85); 1.45 (95% CI 0.85-2.49); 2.14 (95% CI 1.02-4.49); 1.08 (95% CI 1.03-1.13); and 1.21 (95% CI 0.67-2.18). Multivariate analysis showed only increased NLR affected PFS significantly with HR 1.06 (95% CI 1.007-1.13). Conclusion: Median PFS of EGFR positive mutation advanced lung adenocarcinoma patients who received TKI was 12 months and minimum value was 3 months. Increased age, smoking, distant metastases, brain metastases, and exon 21 mutations were not associated with PFS. NLR significantly affected PFS.
导读:目前,关于实体瘤初始反应评价标准(RECIST)及其频率的建议仍然存在差异,而早期进展的诊断影响患者的预后和后续治疗选择。方法:本研究旨在探讨EGFR阳性突变接受酪氨酸激酶抑制剂(Tyrosine Kinase Inhibitor, TKI)治疗的晚期肺腺癌患者的无进展生存期(PFS)及其影响因素。这是一项回顾性队列设计的观察性研究,于2021年1月至12月在IGNG Ngoerah教授医院进行。样本数据来自表皮生长因子受体(EGFR)阳性突变晚期肺腺癌患者,该患者于2017年1月至2021年2月在巴厘岛登巴萨的IGNG Ngoerah医院接受EGFR- tki治疗。总样本数为63。结果:中位PFS为12个月(95% CI 10.28-13.71),最小PFS为3个月。在单因素分析中,年龄较大、吸烟者、远处转移、脑转移、中性粒细胞/淋巴细胞比值(NLR)升高、21外显子突变导致PFS缩短的风险比(HR)为0.99 (95% CI 0.95 ~ 1.02);1.03 (95% ci 0.57-1.85);1.45 (95% ci 0.85-2.49);2.14 (95% ci 1.02-4.49);1.08 (95% ci 1.03-1.13);1.21 (95% CI 0.67-2.18)。多变量分析显示,只有NLR增加显著影响PFS, HR为1.06 (95% CI 1.007-1.13)。结论:EGFR阳性突变晚期肺腺癌患者接受TKI治疗的中位PFS为12个月,最小值为3个月。年龄增加、吸烟、远处转移、脑转移和21外显子突变与PFS无关。NLR显著影响PFS。