title: The Impact of Sequence of Chemotherapy and EGFR-TKI Treatment on Different EGFR Mutation Lung Adenocarcinoma.
abstract: OBJECTIVE
  Chemotherapy as first-/second-line treatment in different epidermal growth factor receptor (EGFR) mutation lung adenocarcinoma remains controversial.
  
  
  METHODS
  Consecutive patients were collected between 2009 and 2012. Patients were divided into two groups (1st-line chemotherapy: n = 56 and 2nd-line chemotherapy: n = 55). Their outcomes profiles were analyzed.
  
  
  RESULTS
  The overall survival (OS) of all patients (390 versus 662 days, p < 0.0001), as well as both progression-free survival (PFS, 151 versus 252 days, p = 0.0001) and OS (308 versus 704 days, p = 0.0001) of patients with L858R mutation (n = 63), who received 2nd-line chemotherapy, was significantly poor. By univariate and multivariate analysis, 2nd-line chemotherapy, and L858R mutation were significantly related to poor PFS and OS.
  
  
  CONCLUSIONS
  In advanced lung adenocarcinoma, L858R mutation and 2nd-line chemotherapy caused a poor outcome. It is a consideration to choice of 1st-line chemotherapy in these subjects. A prospective design is warranted to confirm this finding.
authors.affiliation: Department of Thoracic Medicine, Saint Paul's Hospital, Taoyuan 330, Taiwan ; Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Saint Paul's Hospital, Taoyuan 330, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Fu-Tsai
authors.initials: FT
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Ming-Yun
authors.initials: MY
authors.lastname: Ho
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Yueh-Fu
authors.initials: YF
authors.lastname: Fang
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Meng-Heng
authors.initials: MH
authors.lastname: Hshieh
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Tsai-Yu
authors.initials: TY
authors.lastname: Wang
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Chih-Hsi
authors.initials: CH
authors.lastname: Kuo
authors.affiliation: Department of Internal Medicine, Saint Paul's Hospital, Taoyuan 330, Taiwan.
authors.forename: Hao-Cheng
authors.initials: HC
authors.lastname: Chen
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Chun-Hwa
authors.initials: CH
authors.lastname: Wang
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Shu-Min
authors.initials: SM
authors.lastname: Lin
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Chih-Teng
authors.initials: CT
authors.lastname: Yu
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Horng-Chyuan
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Thoracic Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan ; Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University, College of Medicine, Taipei 10507, Taiwan.
authors.forename: Han-Pin
authors.initials: HP
authors.lastname: Kuo
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics*; D000077192:Adenocarcinoma of Lung; D000368:Aged; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D011446:Prospective Studies; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors