Back to Journals » Lung Cancer: Targets and Therapy » Volume 8

Trajectory of chemotherapy for patients with EGFR wild-type advanced pulmonary adenocarcinoma: a single-institution retrospective study

Authors Minami S, Ogata Y, Ihara S, Yamamoto S, Komuta K

Received 10 October 2016

Accepted for publication 11 November 2016

Published 22 February 2017 Volume 2017:8 Pages 21—30

DOI https://doi.org/10.2147/LCTT.S124301

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Pan-Chyr Yang

Seigo Minami, Yoshitaka Ogata, Shouichi Ihara, Suguru Yamamoto, Kiyoshi Komuta

Department of Respiratory Medicine, Osaka Police Hospital, Osaka, Japan

Background: Pulmonary adenocarcinoma, recently benefited by new cytotoxic and molecularly targeted drugs, has been classified by driver mutations, such as EGFR mutations. The aim of this study was to research the proportions of patients treated with first- to third-line chemotherapy and to find influential factors for the introduction of chemotherapy and survival benefit from chemotherapy.
Materials and methods: Data were collected retrospectively on patients who met the following criteria: adenocarcinoma, diagnosed between June 2007 and March 2015 at our hospital, stage IIIB or IV, and EGFR wild type. A nonchemotherapy group of patients who did not receive chemotherapy was compared with a chemotherapy group of patients who received it. The patients who had received first- to third-line chemotherapy between June 2007 and November 2015 at our hospital were also analyzed.
Results: During the study period, 46 patients did not receive chemotherapy, while 148, 89, and 48 received first-, second- and third-line chemotherapy, respectively. As predictive factors for unlikely chemotherapy, multivariate logistic analysis detected Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2, hemoglobin <13.2 g/dL, creatinine clearance (Ccr) <50.4 mL/min, and CRP ≥0.53 mg/dL. As factors predicting shorter survival after chemotherapy, multivariate Cox proportional-hazard analyses detected age ≥75 years, ECOG PS ≥2, lower lymphocyte counts, and higher CRP for the first line; female, higher neutrophil counts, lower lymphocyte counts, reduced Ccr, hyponatremia, and shorter interval between first- and second-line chemotherapy for the second line; and age ≥75 years, body mass index <18.5 kg/m2, higher neutrophil counts, lower lymphocyte counts, hyponatremia, higher lactate dehydrogenase, and higher CRP for the third line.
Conclusion: Approximately 76% of patients were treated with first-line chemotherapy. Of those patients, 61% and 34% proceeded to second- and third-line chemotherapy, respectively. For patients with poor PS, anemia, reduced Ccr, and higher CRP, it is difficult to introduce chemotherapy.

Keywords:
adenocarcinoma, non-small-cell lung cancer, first-line chemotherapy, second-line chemotherapy, third-line chemotherapy, EGFR wild type

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Other articles by this author:

Outcomes and prognostic factors of chemotherapy for patients with locally advanced or metastatic pulmonary squamous cell carcinoma

Minami S, Ogata Y, Ihara S, Yamamoto S, Komuta K

Lung Cancer: Targets and Therapy 2016, 7:99-110

Published Date: 24 August 2016

Retrospective analysis of outcomes and prognostic factors of chemotherapy for small-cell lung cancer

Minami S, Ogata Y, Ihara S, Yamamoto S, Komuta K

Lung Cancer: Targets and Therapy 2016, 7:35-44

Published Date: 5 April 2016

Combination chemotherapy of gemcitabine and vinorelbine for pretreated non-small- cell lung cancer: a retrospective study

Minami S, Ogata Y, Yamamoto S, Komuta K

Lung Cancer: Targets and Therapy 2015, 6:83-90

Published Date: 25 September 2015

Influence of indacaterol on daily physical activity in patients with untreated chronic obstructive pulmonary disease

Nishijima Y, Minami S, Yamamoto S, Ogata Y, Koba T, Futami S, Komuta K

International Journal of Chronic Obstructive Pulmonary Disease 2015, 10:439-444

Published Date: 27 February 2015