Effectiveness of Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor (TKI) on Life Expectancy in Non-Small Cell Lung Cancer Patients in Medan City

Putri Wulandari Harahap; Setia Putra Tarigan; Noni Novisari Soeroso; Taufik Ashar

doi:10.71197/jsocmed.v4i2.193

Effectiveness of Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor (TKI) on Life Expectancy in Non-Small Cell Lung Cancer Patients in Medan City

Putri Wulandari Harahap
Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara
Setia Putra Tarigan
Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara.
Noni Novisari Soeroso
Division of Thoracic Oncology, Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara.
Taufik Ashar
Department of Environmental Health, Faculty of Public Health.

Abstract

Introduction: Non-small cell lung cancer (NSCLC) is strongly linked to epidermal growth factor receptor (EGFR) mutations, with tyrosine kinase inhibitors (TKIs) serving as a primary treatment. While TKIs demonstrate substantial antitumor effects, resistance differs across generations. This study evaluates the impact of first- and second-generation EGFR TKIs on the survival outcomes of NSCLC patients in Medan.

Method: A retrospective cross-sectional study was conducted on 67 EGFR-positive NSCLC patients treated with TKIs between 2017 and 2022. Medical records from four hospitals-Haji Adam Malik Hospital, Elisabeth Hospital, Prof. Dr. Chairuddin Panusunan Lubis USU Hospital, and Pirngadi Hospital-were analyzed. Patients aged >18 years with EGFR mutations (exon 18, 19, or 21) and complete records were included. Survival outcomes, including Progression-Free Survival (PFS), Median Survival Time (MST), and Overall Survival (OS), were compared using the Mann-Whitney test.

Results: All 67 patients received either first- or second-generation TKIs. Statistical analysis revealed that patients treated with second-generation TKIs had significantly better PFS, MST, and OS than those receiving first-generation TKIs (p < 0.05).

Conclusion: This retrospective study faced limitations due to incomplete data and did not assess adverse effects. However, findings indicate that second-generation EGFR TKIs provide superior survival benefits for NSCLC patients compared to first-generation TKIs. Further prospective studies are needed to validate these results and explore the impact of treatment-related toxicity.

Similar Articles

Amalia Noor Zafira Nasution, Aldy S Rambe , Haflin Soraya Hutagalung , Relation between Parkinson's Disease Severity and Cognitive Function with Monstreal Cognitive Assessment Indonesia , Journal of Society Medicine: Vol. 2 No. 9 (2023): September
Putri Nahrisyah, Fajrinur Syahrani, Amira Permatasari Tarigan, Taufik Ashar, Survival Rate of Chronic Obstructive Pulmonary Disease Patients with Type II Respiratory Failure at Haji Adam Malik Hospital , Journal of Society Medicine: Vol. 3 No. 8 (2024): August
Harel Mega Serafine Simanjuntak, Haflin Soraya Hutagalung, Indri Adriztina, Sri Amelia, Relationship Between Sleep Quality and Primary Headache Among Employees of PT. Valeo Ac Indonesia , Journal of Society Medicine: Vol. 3 No. 12 (2024): December
Edlin, Mual Kristian Sinaga, Prolotherapy in Chronic Coccydynia , Journal of Society Medicine: Vol. 2 No. 2 (2023): February
Angela Yurika Purba, Syamsul Bihar, Bintang Y.M. Sinaga, Correlation Between Neutrophil to Lymphocyte Ratio (NLR) and Procalcitonin Levels in Sepsis Pneumonia Patients , Journal of Society Medicine: Vol. 3 No. 11 (2024): November
Azwar Iwan Tona, Maimun Syukri, Role of Glucagon in The Metabolic Response: Review , Journal of Society Medicine: Vol. 2 No. 2 (2023): February
Fadli Ilhami, Ali Nafiah Nasution, Cut Aryfa Andra, Prognostic Value of Tricuspid Annular Plane Systolic Excursion (TAPSE), Right Ventricular Fractional Area Changes (RV FAC) and Pulses Tissue Doppler S' Wave (PTD S') at 30 Days after Care of Acute Miocardial Infarction Patients in Haji Adam Malik Hospital , Journal of Society Medicine: Vol. 2 No. 5 (2023): May
Army Zaka Anwary, Indriasari, Role of CRRT (Continuous Renal Replacement Therapy) as Management of Cardiac Arrest Patient with Postpartum Acute Lung Edema and Cardiomyopathy in the ICU , Journal of Society Medicine: Vol. 2 No. 6 (2023): June
Billi, Muhammad Akbar, David Gunawan Umbas, Firdaus Hamid, Andi Kurnia Bintang, Mimi Lotisna, Estimated Glomerular Filtration Rate (eGFR) as a Predictor of 1-Month Clinical Outcome in First-Ever Acute Ischemic Stroke Patients , Journal of Society Medicine: Vol. 2 No. 12 (2023): December
Adi Retno, Evo Elidar Harahap, Bayu Rusfandi Nasution, Relationship between Stage of Chronic Kidney Disease with Cardiomegaly Imaging in Posteroanterior Chest X-Ray at Haji Adam Malik Hospital Medan , Journal of Society Medicine: Vol. 2 No. 8 (2023): August

<< < 2 3 4 5 6 7 8 > >>

You may also start an advanced similarity search for this article.

PDF

Published at

28. February 2025
https://doi.org/10.71197/jsocmed.v4i2.193
Issue:

Vol. 4 No. 2 (2025): February
Section:

Articles
Keywords:

Life Expectancy Effectiveness Epidermal Growth Factor Receptor Non-Small Cell Lung Cancer Tyrosine Kinase Inhibitor
References:

World Health Organization. Cancer. Available. Accessed. 2024; 11; 1-6.

Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71: 209-249.

Fajrinur F, Handini MC, Tarigan FL, Siregar G, Sihombing P, Simanjuntak R, et al. Ketidaklengkapan Pengisian Dokumen Clinical Pathway Kanker Paru (Studi Kualitatif di RSUP H. Adam Malik tahun 2021). J Healthc Technol Med. 2022; 8: 34-45.

Siddiqui F, Vaqar S, Siddiqui AH, Rahman S, Khan M, Ahmed R, et al. Lung Cancer. Cambridge Handbook of Psychology, Health and Medicine, Second Edition. 2023: 605-606.

Wright NMA, Goss GD, Patel JD, Lee JS, Chen Y, Kim ES, et al. Third-generation epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small cell lung cancer. Transl Lung Cancer Res. 2019; 8: 234-256.

Sigismund S, Avanzato D, Lanzetti L, Ferrari L, Mancini M, Rossi G, et al. Emerging functions of the EGFR in cancer. Mol Oncol. 2018; 12: 3-20.

Bartholomew C, Eastlake L, Dunn P, Anderson C, Smith K, Green J, et al. EGFR targeted therapy in lung cancer; an evolving story. Respir Med Case Rep. 2017; 20: 45-60.

Chi A, Remick S, Tse W, Morgan G, Li H, Wang X, et al. EGFR inhibition in non-small cell lung cancer: Current evidence and future directions. Biomark Res. 2013; 1: 15-27.

Ellis PM, Coakley N, Feld R, Johnson DH, Shepherd FA, Mok TS, et al. Use of the epidermal growth factor receptor inhibitors gefitinib, erlotinib, afatinib, dacomitinib, and icotinib in the treatment of non-small-cell lung cancer: A systematic review. Curr Oncol. 2015; 22: 233-250.

Tan CS, Kumarakulasinghe NB, Huang YQ, Ang YL, Soo RA, Tan DS, et al. Third generation EGFR TKIs: Current data and future directions. Mol Cancer. 2018; 17: 456-472.

Kim Y, Lee SH, Ahn JS, Jung KH, Park K, Lee KH, et al. Efficacy and safety of afatinib for EGFR-mutant non-small cell lung cancer, compared with gefitinib or erlotinib. Cancer Res Treat. 2019; 51: 345-360.

Brzozowska M, Wierzba W, Szafraniec-Buryło S, Kowalska M, Nowak P, Jankowski A, et al. Overall survival of patients with EGFR mutation-positive non-small-cell lung cancer treated with erlotinib, gefitinib or afatinib under drug programmes in Poland – Real-World Data. Arch Med Sci. 2019; 25: 215-230.

Lahmadi M, Beddar L, Rouibah AL, Belhadj S, Boukhatem N, Cherif H, et al. Analysis of EGFR Mutation Status in Algerian Patients with Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev. 2021; 22: 123-135.

Bian D, Sun L, Hu J, Wang Y, Zhou X, Liu P, et al. Neoadjuvant Afatinib for stage III EGFR-mutant non-small cell lung cancer: a phase II study. Nat Commun. 2023; 14: 789-803.

Rodak O, Peris-Díaz MD, Olbromski M, Kowalczyk A, Nowicki M, Zielinski T, et al. Current landscape of non-small cell lung cancer: Epidemiology, histological classification, targeted therapies, and immunotherapy. Cancers (Basel). 2021; 13: 987-1005.

Hsu WH, Yang JCH, Mok TS, Lee VHF, Kuo CW, Ho CC, et al. Overview of current systemic management of EGFR-mutant NSCLC. Ann Oncol. 2018; 29: 226-240.

Sari S, Andayani TM, Endarti D, Rahmat D, Widiastuti D, Santoso B, et al. Efikasi Afatinib dan Gefitinib pada Pasien Non-small Cell Lung Cancer EGFR Mutasi Positif: Tinjauan Sistematis. Indones J Clin Pharm. 2019; 8: 179-192.

Wu SG, Chang YL, Yu CJ, Yang PC, Lin CC, Lin YC, et al. Lung adenocarcinoma patients of young age have lower EGFR mutation rate and poorer efficacy of EGFR tyrosine kinase inhibitors. ERJ Open Res. 2017; 3: 456-472.

Kobayashi Y, Togashi Y, Yatabe Y, Hayashi H, Nishikawa H, Shibata Y, et al. EGFR Exon 18 Mutations in Lung Cancer: Molecular Predictors of Augmented Sensitivity to Afatinib or Neratinib as Compared with First- or Third-Generation TKIs. Clin Cancer Res. 2015; 21: 4325-4337.

Zheng M. Classification and Pathology of Lung Cancer. Surg Oncol Clin N Am. 2016; 25: 455-469.

Choi MK, Ahn JS, Kim YC, Choi H, Park SY, Kim JY, et al. Afatinib in heavily pretreated advanced NSCLC patients who progressed following prior gefitinib or erlotinib: Compassionate use program in Korea. Lung Cancer. 2018; 119: 78-90.

Kuan FC, Li SH, Wang CL, Hsieh CC, Cheng YL, Huang SF, et al. Analysis of progression-free survival of first-line tyrosine kinase inhibitors in patients with non-small cell lung cancer harboring leu858Arg or exon 19 deletions. Oncotarget. 2017; 8: 1234-1250.

Hsu PC, Jablons DM, Yang CT, Lin MW, Hsiao YW, Wang CC, et al. Epidermal growth factor receptor (EGFR) pathway, yes-associated protein (YAP) and the regulation of programmed death-ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC). Int J Mol Sci. 2019; 20: 1023-1038.
Share:

Z

Harahap, P. W., Tarigan, S. P., Soeroso, N. N., & Ashar, T. (2025). Effectiveness of Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor (TKI) on Life Expectancy in Non-Small Cell Lung Cancer Patients in Medan City. Journal of Society Medicine, 4(2), 34–42. https://doi.org/10.71197/jsocmed.v4i2.193