Concomitant Pulmonary Tuberculosis Impair Survival in Advanced Epidermal Growth Factor Receptor (EGFR) Mutant Lung Adenocarcinoma Patients Receiving EGFR-Tyrosine Kinase Inhibitor

• Main Authors: Xie Y, Su N, Zhou W, Lei A, Li X, Li W, Huang Z, Cen W, Hu J
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-10-01
• Series: Cancer Management and Research
• Subjects: advanced lung adenocarcinoma; pulmonary tuberculosis; egfr mutation; egfr-tyrosine kinase inhibitors; prognosis
• Online Access: https://www.dovepress.com/concomitant-pulmonary-tuberculosis-impair-survival-in-advanced-epiderm-peer-reviewed-fulltext-article-CMAR

Yalin Xie,1 Ning Su,1 Wei Zhou,2 An Lei,1 Xiang Li,3 Weiwei Li,4 Zhan Huang,4 Wenchang Cen,1 Jinxing Hu5 1Department of Oncology, Guangzhou Chest Hospital, Guangzhou, People’s Republic of China; 2Department of Pathology, Guangzhou Chest Hospital, Guangzhou, People’s Republic of China; 3Department of Pharmacy, Guangzhou Chest Hospital, Guangzhou, People’s Republic of China; 4Department of Medical Business, Amoy Diagnostics Co., Ltd., Xiamen, People’s Republic of China; 5Department of Tuberculosis, Guangzhou Chest Hospital, Guangzhou, People’s Republic of ChinaCorrespondence: Wenchang Cen; Jinxing Hu Email [e-mail]; [e-mail]: Limited studies have clearly demonstrated the effect of EGFR-TKI in the treatment of EGFR mutant NSCLC patients with underlying pulmonary disease, like pulmonary tuberculosis (PTB). Here, we conducted the study to evaluate the impact of PTB on survival of Chinese EGFR mutant lung adenocarcinoma (LUAD) patients that underwent EGFR-TKI treatment.Methods: Clinicopathologic data of 1448 LUAD patients harboring EGFR mutations from the Guangzhou Chest Hospital between 2017 and 2019 were reviewed retrospectively. Patients receiving EGFR-TKI treatment were divided into PTB and non-PTB groups. The differences in response to EGFR-TKIs and survival between the two groups were assessed.Results: After EGFR-TKIs treatment, the objective response rate (58.14% vs 47.62%) as well as disease control rate (97.67% vs 85.71%) were higher in the non-PTB group than in the PTB group, but there was no statistical difference. In the survival analysis, both the median progression-free survival (7.47 months vs 11.77 months, p = 0.038) and the overall survival (13.00 months vs 20.00 months, p = 0.001) were significantly shorter in the PTB group than in the non-PTB group. Furthermore, for patients with 19Del mutation, or metastases sites less than 3, or using first-line EGFR-TKI, EGFR-TKIs treatment significantly prolonged the median PFS and OS in patients without PTB.Conclusion: LUAD patients with concomitant PTB have a poor response to EGFR-TKI treatment, especially in terms of survival outcome.Keywords: advanced lung adenocarcinoma, pulmonary tuberculosis, EGFR mutation, EGFR-tyrosine kinase inhibitors, prognosis