title: Subsequent treatment of epidermal growth factor receptor-tyrosine kinase inhibitor failure in patients with advanced lung adenocarcinoma.
abstract: BACKGROUND
  Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) effectively treat advanced non-small cell lung cancer with EGFR-mutation. However, most patients develop acquired resistance without effective therapy subsequent to EGFR-TKI failure. We evaluated the efficacy of subsequent treatment strategies for EGFR-TKI resistance.
  
  
  METHODS
  We retrospectively analyzed 240 patients with advanced lung adenocarcinoma with EGFR-TKI failure and following subsequent treatment. According to the first subsequent strategies after EGFR-TKI failure, patients were divided into groups of EGFR-TKI continuation (21 cases), EGFR-TKI continuation with chemotherapy (23 cases), chemotherapy alone (143 cases), and best supportive care (BSC) (53 cases).
  
  
  RESULTS
  Except for 53 cases of BSC, the disease control rates (DCR) of the remaining 187 patients in the EGFR-TKI continuation, EGFR-TKI continuation with chemotherapy, and chemotherapy alone groups were 66.7%, 73.9%, and 44.8%, respectively. The median post-progression progression-free survival (PFS) for the three groups was 3.0, 3.3, and 2.0 months, respectively. The DCR for the EGFR-TKI continuation with chemotherapy group was significantly higher than the chemotherapy alone group (P = 0.006). The post-progression PFS of the EGFR-TKI continuation with chemotherapy group was significantly longer than the chemotherapy alone group (P = 0.037). The median overall survival in the EGFR-TKI continuation, EGFR-TKI continuation with chemotherapy, chemotherapy alone, and BSC groups were 6.9, 11.6, 8.8, and 0.9 months, respectively. Compared to the BSC group, all groups achieved a survival benefit (P < 0.001).
  
  
  CONCLUSIONS
  EGFR-TKI continuation with chemotherapy could provide benefits for patients with acquired resistance to EGFR-TKI.
authors.affiliation: Department of Cellular and Molecular Biology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China ; Health Care Ward, The First Affiliated Hospital of Inner Mongolia Medical University Hohhot, China.
authors.forename: Xiaojuan
authors.initials: X
authors.lastname: Qiao
authors.affiliation: Department of Pharmacology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Jinghui
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Jingying
authors.initials: J
authors.lastname: Nong
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Xinjie
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Jialin
authors.initials: J
authors.lastname: Lv
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Na
authors.initials: N
authors.lastname: Qin
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Cellular and Molecular Biology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Wentao
authors.initials: W
authors.lastname: Yue
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute Beijing, China.
authors.forename: Shucai
authors.initials: S
authors.lastname: Zhang
keywords: Epidermal growth factor receptor; failure; lung adenocarcinoma; tyrosine kinase inhibitor