title: Gender-based impact of epidermal growth factor receptor mutation in patients with nonsmall cell lung cancer and previous tuberculosis.
abstract: The association between tuberculosis (TB) and lung cancer is well known. However, carcinogenesis of TB and its connection with epidermal growth factor receptor (EGFR) mutation remains unclear. This study aimed to determine this connection to see if TB can affect the outcome of patients with lung cancer. This is a retrospective cohort study of patients with lung cancer receiving EGFR-tyrosine kinase inhibitors (TKIs) between 1996 and 2010 using the National Health Insurance Research Database of Taiwan. Because therapeutic response was required to apply EGFR-TKIs for >90 days, only patients with a follow-up of >120 days were studied and a responder was defined as intake of EGFR-TKIs >90 days. Predictors of EGFR-TKI response and survival were identified using logistic and Cox regression analyses, respectively. There were 8265 patients analyzed, including 6073 (73.5%) EGFR-TKI responder and 2192 (26.5%) nonresponder. A history of TB was found in 1.2% and 1.8% of the 2 groups, respectively. Comparing to male with pulmonary TB history, female with or without pulmonary TB history and male without pulmonary TB history all had a better EGFR-TKI response and 1-year progression-free survival (PFS). Gender and TB history were not independent prognostic factors of 2-year overall survival. The findings were similar in the subpopulation without chronic obstructive pulmonary disease, malignancies other than lung cancer, and low-income status. TB has a gender-dependent impact, with better EGFR-TKI response and 1-year PFS in female patients with lung cancer. The carcinogenesis and inflammation of TB may be different between genders.
authors: From the Department of Internal Medicine (C-HC), National Taiwan University Hospital, HsinChu; Department of Pulmonary Medicine (C-HL), Wanfang Hospital, Taipei Medical University; and Department of Internal Medicine (C-CH, J-YW, C-JY), National Taiwan University Hospital, Taipei, Taiwan.
authors: Chia-Hao
authors: CH
authors: Chang
authors: Chih-Hsin
authors: CH
authors: Lee
authors: Chao-Chi
authors: CC
authors: Ho
authors: Jann-Yuan
authors: JY
authors: Wang
authors: Chong-Jen
authors: CJ
authors: Yu
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics / Q000401:mortality*; D015331:Cohort Studies; D066246:ErbB Receptors / Q000235:genetics*; D000069347:Erlotinib Hydrochloride; D005260:Female; D005500:Follow-Up Studies; D000077156:Gefitinib; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D012189:Retrospective Studies; D012737:Sex Factors; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000077156:Gefitinib
references: PLoS One. 2012;7(5):e37978
references: 22662259
references: Ann Oncol. 2013 Oct;24(10):2699-2704
references: 23894040
references: Tuber Lung Dis. 1996 Oct;77(5):401-6
references: 8959142
references: J Thorac Oncol. 2014 Feb;9(2):154-62
references: 24419411
references: J Thorac Oncol. 2011 Jan;6(1):32-7
references: 21150470
references: PLoS Med. 2009 Dec;6(12):e1000199
references: 20027210
references: Clin Microbiol Infect. 2012 Sep;18(9):E331-7
references: 22734962
references: J Natl Cancer Inst. 2013 May 1;105(9):595-605
references: 23594426
references: Int J Cancer. 2009 Mar 1;124(5):1183-7
references: 19058197
references: Thorax. 2006 Nov;61(11):935-9
references: 17071833
references: Eur J Biochem. 2003 Apr;270(8):1828-37
references: 12694196
references: N Engl J Med. 2009 Sep 3;361(10):947-57
references: 19692680
references: PLoS One. 2012;7(3):e33226
references: 22438899
references: Int J Tuberc Lung Dis. 2011 Jun;15(6):838-43
references: 21575308
references: Gend Med. 2010 Oct;7(5):381-401
references: 21056866
references: Lung Cancer. 2008 Oct;62(1):78-84
references: 18423781
references: Int J Cancer. 2009 Dec 15;125(12):2936-44
references: 19521963
references: Lancet Oncol. 2009 May;10(5):432-3
references: 19410185
references: Cancer Epidemiol Biomarkers Prev. 2011 Feb;20(2):262-71
references: 21177425
references: Lung Cancer. 2012 Jun;76(3):452-6
references: 22226628
references: JAMA. 2005 Sep 28;294(12):1505-10
references: 16189363
references: J Thorac Oncol. 2012 Feb;7(2):299-305
references: 22173705
references: Lancet. 2001 Feb 17;357(9255):539-45
references: 11229684
references: J Infect Dis. 2011 May 1;203(9):1240-8
references: 21357942
references: Ann N Y Acad Sci. 2012 Feb;1248:107-23
references: 22092035
references: J Immunol. 1991 Jun 15;146(12):4362-7
references: 1904081
references: J Clin Oncol. 2005 Feb 1;23(4):857-65
references: 15681531
references: Nature. 2002 Dec 19-26;420(6917):860-7
references: 12490959
references: Chest. 2005 Jul;128(1):370-81
references: 16002959
references: Oncogene. 2009 Apr 30;28(17):1928-38
references: 19330024
references: Semin Thorac Cardiovasc Surg. 2013 Summer;25(2):87-94
references: 24216523
references: Carcinogenesis. 1996 Oct;17(10):2201-5
references: 8895489
references: Cancer Prev Res (Phila). 2008 Aug;1(3):201-7
references: 19138957
references: Clin Lung Cancer. 2011 May;12(3):148-54
references: 21663856
references: Am J Respir Cell Mol Biol. 2006 May;34(5):581-91
references: 16424381
references: Cancer. 2011 Feb 1;117(3):618-24
references: 20886634
references: Lancet Oncol. 2010 Apr;11(4):321-30
references: 20304703
references: Am J Respir Crit Care Med. 2009 Sep 1;180(5):475-80
references: 19542475
references: BMC Cancer. 2012 May 11;12:174
references: 22578056
references: Oncogene. 2008 Sep 11;27(40):5373-84
references: 18504437
references: Clin Exp Immunol. 2001 Mar;123(3):428-34
references: 11298130
references: CA Cancer J Clin. 2013 Jan;63(1):11-30
references: 23335087
references: J Clin Oncol. 2011 Jul 20;29(21):2866-74
references: 21670455
references: Semin Respir Crit Care Med. 2008 Oct;29(5):481-91
references: 18810682
references: Medicine (Baltimore). 2011 May;90(3):159-167
references: 21512416