Survival of patients with advanced NSCLC treated with first-generation EGFR-TKIs at a cancer hospital in Thailand, 2011-2016.

Sukauichai, Sitthi; Tovanabutra, Chokaew; Wanglikitkul, Sirentra; Chomprasert, Kittisak

doi:10.35841/medical-oncology.3.2.23-31

Cited by 2 publications

(4 citation statements)

References 37 publications

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“…This retrospective study was conducted to determine survival and treatment patterns of patients with advanced NSCLC in the period before EGFR-TKI was listed in the national essential drug in Thailand and could be reimbursed by all health fund groups. Prior to 2020, only patients with GSEO could receive reimbursement for the medication as 2L or more, while those with UC and SSS needed to pay out of pocket for access to the drug [22][23].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the waiting time from the diagnosis of lung cancer to EGFR mutation status report, either from tissue or plasma testing, was approximately 3 weeks long, which lead to delays in TKI treatment. Based on a previous study waiting time for the EGFR report in Thailand is influenced by processing time including referral time and/or tissue paraffin-block request time rather than turn-around time of EGFR mutation testing [23].…”

Section: Discussionmentioning

confidence: 99%

“…In Thailand, EGFR-TK1 was not approved for the list of national essential drugs until October 2020 mainly due to the cost of the medication. Previously, only patients with government servant and state enterprise officer coverage (GSEO) could receive reimbursement for the medication as late-line treatment, regardless of EGFR mutation status, while patients with universal coverage (UC) or the social security scheme coverage (SSS) needed to pay out of pocket [22][23]. There were scant data regarding survival of patients with EGFR mutated lung cancer prior to the introduction of EGFR-TK1 in Thailand [23][24].…”

Section: Introductionmentioning

confidence: 99%

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EGFR Mutation-positive Lung Cancer in Real-world Treatment Outcomes: A Multicenter Study from Thailand

Sukauichai

Maneenil

Supavavej

et al. 2022

Asian Pac J Cancer Care

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Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) have been the standard of care as first-line (1L) therapy for patients with advanced EGFR mutated lung cancer since 2009. In Thailand, however, it was not fully introduced to all health care funds until 2020. The purpose of this study was to determine the overall survival (OS) and treatment pattern in the period before EGFR-TKI became universally available to all patients. Methods: This was a retrospective study conducted at 10 medical centers in Thailand. Patients harboring the common mutation (exon 19 deletion or exon 21 L858R) diagnosed during January 2013 and December 2019 were enrolled. Results: This study included 284 patients with a median follow-up time of 19.8 months and a death rate of 80.3% (228/284). Clinical characteristics included median age 62.5 years, female 65.5%, never-smoking 74.3%, stage 3B/4/recurrence 2.1/93.3/4.6%, exon 19/exon 21- 60.9/38.7%. Treatment patterns to EGFR-TKI included not receiving (NR) (9.5%), first-line (1L) (56.0%), switch maintenance (MN) (3.5%), second-line (2L) (21.8%) and third-line (3L) or more (9.2%). Median OS of patient receiving EGFR-TKI as NR, 1L+MN, 2L and 3L or more was 11.10 (95%CI: 8.21 to14.00), 19.08 (95%CI: 15.76 to 22.41), 23.06 (95%CI: 15.91 to 30.21) and 32.46 (95%CI: 21.61 to 43.30) months (p=0.006), respectively. Factors contributing to poor prognosis in the multivariate model included poor ECOG-PS (HR 3.17, 95%CI: 1.96-5.13), not receiving EGFR-TKI (HR 3.83, 95%CI, 1.94-7.56) and receiving EGFR-TKI 1L (HR 2.30, 95%CI: 1.40-3.79) Conclusion: OS of patients with EGFR mutation positive lung cancer treated with EGFR-TKIs in Thailand was comparable to clinical studies. EGFR-TKI treatment should be provided to patients as early as possible, but TKI remained beneficial at later points in the treatment timeline.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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EGFR Mutation-positive Lung Cancer in Real-world Treatment Outcomes: A Multicenter Study from Thailand

Sukauichai

Maneenil

Supavavej

et al. 2022

Asian Pac J Cancer Care

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“…Survival of patients with advanced NSCLC treated with first-generation EGFR-TKIs at a cancer hospital in Thailand (between 2011 and 2016). The respective overall observed survival rates of patients receiving EGFR-TKIs as first-line or maintenance (n=18), second-line (n=18), and third-line or more (n=14) was 15.9% (95%CI: 10.26 to 21.46), 10.9% (95%CI: 0.00 to 28.29), and 20.2% (95%CI: 6.26 to 34.21) (Sukauichai et al, 2018 ).…”

Section: Survival Of Lc By Targeted Therapymentioning

confidence: 99%

Lung Cancer Survival with Current Therapies and New Targeted Treatments: A Comprehensive Update from the Srinagarind Hospital-Based Cancer Registry from (2013 to 2017)

Musika¹,

Kamsa‐ard

Jirapornkul

et al. 2021

Asian Pac J Cancer Prev

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Background: Lung cancer (LC) is a common malignancy and leading cause of cancer death worldwide and in Thailand. An update on LC survival factors after diagnosis at Srinagarind Hospital is needed. Methods: We conducted a retrospective cohort study, and the data were sourced from the Srinagarind Hospital-Based Cancer Registry. All LC cases were diagnosed between January 1, 2013, and December 31, 2017, and followed up until November 30, 2019. Cases of LC (ICD-O-3) numbered 2,149, but only those with coding C34.0-C34.9 were included. The survival rate was estimated using Kaplan-Meier, while the Log-rank test was used to estimate survival. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard regression models. Results: The 2,149 patients had a total follow-up of 269.6 person-years. Overall, 1,867 patients died during the study, for a corresponding case-fatality mortality rate of 86.0 per 100 person-years. The respective 1-, 3-, and 5-year survival rate was 31.2 % (95% CI; 29.21 to 33.15%), 12.9 % (95%CI: 11.49 to 14.45), and 10.2% (95%CI: 8.74 to 11.70). After patient diagnosis, the median survival time was 0.46 years (5.51 months) (95% CI: 0.42 to 0.50). Targeted therapy was associated with longer survival than non-targeted therapy (p-value < 0.001). After adjusting for sex, TNM stage, and histologic type, multivariable analysis of the entire cohort identified chemotherapy as an independent predictor of improved survival (adjusted HR= 0.48; 95% CI: 0.42 to 0.55; P < 0.001), and that sex, TNM stage, and histologic type were associated with survival. Conclusion: The study confirmed that sex, stage of disease, histology, and chemotherapy are associated with survival of LC. Primary prevention and screening for early detection improve survival. Further investigations into factors affecting survival of LC in Northeast Thailand should focus on targeted therapy.

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Survival of patients with advanced NSCLC treated with first-generation EGFR-TKIs at a cancer hospital in Thailand, 2011-2016.

Cited by 2 publications

References 37 publications

EGFR Mutation-positive Lung Cancer in Real-world Treatment Outcomes: A Multicenter Study from Thailand

EGFR Mutation-positive Lung Cancer in Real-world Treatment Outcomes: A Multicenter Study from Thailand

Lung Cancer Survival with Current Therapies and New Targeted Treatments: A Comprehensive Update from the Srinagarind Hospital-Based Cancer Registry from (2013 to 2017)

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