TY - JOUR
T1 - Propensity score analysis of overall survival between first- and second-generation EGFR-TKIs using real-world data
AU - Ito, Kentaro
AU - Murotani, Kenta
AU - Kubo, Akihito
AU - Kunii, Eiji
AU - Taniguchi, Hirokazu
AU - Shindoh, Joe
AU - Asada, Kazuhiro
AU - Imaizumi, Kazuyoshi
AU - Takahashi, Kosuke
AU - Karayama, Masato
AU - Okuno, Motoyasu
AU - Inui, Naoki
AU - Hataji, Osamu
AU - Morikawa, Sayako
AU - Hayai, Shunsaku
AU - Suda, Takafumi
AU - Abe, Takashi
AU - Tsuda, Takeshi
AU - Yamagichi, Teppei
AU - Kimura, Tomoki
AU - Oya, Yuko
AU - Yoshida, Tatsuya
AU - Hida, Toyoaki
N1 - Publisher Copyright:
© 2020 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association
PY - 2020/10/1
Y1 - 2020/10/1
N2 - We constructed a data set of EGFR-mutant non–small-cell lung carcinoma (NSCLC) patients, and compared the overall survival of first-generation (1G), and second-generation (2G) EGFR-tyrosine kinase inhibitors (TKIs) in clinical practice using a propensity score. We reviewed the clinical data of consecutive EGFR-mutated NSCLC patients who received EGFR-TKI therapy between January 2008 and August 2017 at 11 institutions in Japan. The primary endpoint was overall survival (OS). When comparing OS between 1G and 2G EGFR-TKIs, propensity score analyses were performed using 2 methods: matching and inverse probability of treatment weighting (IPTW). (Clinical Trial information: UMIN000030121) In total, 1400 patients from 11 institutions were enrolled in this study, and the data from the 1366 patients who received only EGFR-TKI therapy were analyzed (gefitinib [GEF], N = 732; erlotinib [ERL], N = 416; afatinib, N = 218). Median OS times (months [95%CI]) were 29.7 [27.5-33.5] in the 1G group (gefitinib, 32.0 [28.1-35.8]; erlotinib, 27.5 [23.9-31.7]), and 38.6 [32.2-NR] in the 2G group (afatinib), respectively. The trend of longer OS for afatinib against 1G EGFR-TKIs remained, even after adjusted by propensity score. (unadjusted, hazard ratio [HR] 0.676, P =.0023; adjusted by IPTW, HR 0.685 P <.0001; adjusted by matching, HR 0.725, P =.0418). Exploratory analysis showed that OS using the 2G EGFR-TKI was superior to that of the 1G EGFR-TKIs, suggesting the potential of sequential therapy of 2G EGFR-TKI followed by osimertinib. (HR 0.419, P =.0519) Real-world data analysis using 1354 data records, using propensity scoring, indicated that 2G EGFR-TKI had a trend of longer OS compared with 1G EGFR-TKIs.
AB - We constructed a data set of EGFR-mutant non–small-cell lung carcinoma (NSCLC) patients, and compared the overall survival of first-generation (1G), and second-generation (2G) EGFR-tyrosine kinase inhibitors (TKIs) in clinical practice using a propensity score. We reviewed the clinical data of consecutive EGFR-mutated NSCLC patients who received EGFR-TKI therapy between January 2008 and August 2017 at 11 institutions in Japan. The primary endpoint was overall survival (OS). When comparing OS between 1G and 2G EGFR-TKIs, propensity score analyses were performed using 2 methods: matching and inverse probability of treatment weighting (IPTW). (Clinical Trial information: UMIN000030121) In total, 1400 patients from 11 institutions were enrolled in this study, and the data from the 1366 patients who received only EGFR-TKI therapy were analyzed (gefitinib [GEF], N = 732; erlotinib [ERL], N = 416; afatinib, N = 218). Median OS times (months [95%CI]) were 29.7 [27.5-33.5] in the 1G group (gefitinib, 32.0 [28.1-35.8]; erlotinib, 27.5 [23.9-31.7]), and 38.6 [32.2-NR] in the 2G group (afatinib), respectively. The trend of longer OS for afatinib against 1G EGFR-TKIs remained, even after adjusted by propensity score. (unadjusted, hazard ratio [HR] 0.676, P =.0023; adjusted by IPTW, HR 0.685 P <.0001; adjusted by matching, HR 0.725, P =.0418). Exploratory analysis showed that OS using the 2G EGFR-TKI was superior to that of the 1G EGFR-TKIs, suggesting the potential of sequential therapy of 2G EGFR-TKI followed by osimertinib. (HR 0.419, P =.0519) Real-world data analysis using 1354 data records, using propensity scoring, indicated that 2G EGFR-TKI had a trend of longer OS compared with 1G EGFR-TKIs.
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U2 - 10.1111/cas.14560
DO - 10.1111/cas.14560
M3 - Article
C2 - 32639668
AN - SCOPUS:85088943431
SN - 1347-9032
VL - 111
SP - 3705
EP - 3713
JO - Cancer science
JF - Cancer science
IS - 10
ER -