EGFR tyrosine kinase inhibitor therapy for lung cancer treatments and their clinical outcomes: A cohort study in Taiwan

Malignant cancer is the top cause of mortality in Taiwan. In particular, the mortality rate of with lung cancer reached 39.2/100,000 in 2017. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are being increasingly used to treat lung cancer.; however, due to small sample sizes and a limited number of adequately controlled studies, it is difficult to compare survival rates of traditional chemotherapy with EGFR-TKI therapy when used as a first- or second-line treatment for patients with lung cancer, and therefore data on its efficacy are inconclusive. Therefore, Taiwan's entire 2010-2015 National Health Insurance Database (NHID) was used to perform a retrospective study. The top two anti-neoplastic first-line therapies used for lung cancer were traditional platinum-based doublet chemotherapy and EGFR-TKI therapy. Patients with stage III and IV lung cancer undergoing first-line EGFR-TKI therapy exhibited improved overall survival rates. However, patients with stage I and II lung cancer demonstrated limited benefits. Patients with stage IIIB and IV EGFR mutation (-) patients did not benefit from treatment with EGFR-TKI therapy. The EGFR-TKI gefitinib may be more effective in patients with lung cancer than erlotinib, irrespective of whether patients had been previously treated or not. Patients treated with Gefitinib also exhibited improved survival rates compared with other frequently used chemotherapeutic drugs.