Prognostic factors affecting survival in third-line treatment of advanced non-small cell lung cancer: Retrospective cohort study

Ferit Aslan; Umut Demirci; Derya Kızılgöz; Fatih Yıldız; Pınar Akın Kabalak; Fatma Buğdaycı Başal; Emrah Eraslan; Ülkü Yılmaz; Berna Öksüzoğlu

doi:10.28982/josam.686819

Authors

Ferit Aslan https://orcid.org/0000-0002-9153-6921
Umut Demirci https://orcid.org/0000-0002-4833-6721
Derya Kızılgöz https://orcid.org/0000-0001-9304-216X
Fatih Yıldız Health Sciences Unıversity Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital , Department of Medical Oncology , Ankara, Turkey https://orcid.org/0000-0003-2295-7332
Pınar Akın Kabalak https://orcid.org/0000-0002-4087-7048
Fatma Buğdaycı Başal Health Sciences Unıversity Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Medical Oncology , Ankara ,Turkey https://orcid.org/0000-0003-1154-5850
Emrah Eraslan Health Sciences Unıversity Ankara Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital , Department of Medical Oncology , Ankara, Turkey https://orcid.org/0000-0003-2497-5913
Ülkü Yılmaz Health Sciences Unıversity Ankara Atatürk Chest Disease and Toracic Surgery Training and Research Hospital , Department of Pulmonology , Ankara, Turkey https://orcid.org/0000-0003-1493-8385
Berna Öksüzoğlu https://orcid.org/0000-0002-2756-8646

DOI:

https://doi.org/10.28982/josam.686819

Keywords:

Third-line treatment, Anti-EGFR, Treatment, Prognosis, Non-small cell lung cancer

Abstract

Aim: In patients who have reached third-line treatment, survival times are short and response to treatment is poor. However, in some patients, survival times and treatment responses are good despite advanced treatment lines. The present study investigates the prognostic factors that affect survival among patients who have undergone third-line treatment for non-small cell lung cancer (NSCLC).
Methods: Among the 1,150 patients who were treated for and followed-up with a diagnosis of NSCLC between January 2008 and December 2015, 102 (8%) who had received third-line treatment were included in this retrospective cohort study.
Results: The mean patient age was 56 years (SD: 10.1), and 70.6% were male. The third-line treatment provided a median PFS of 2.36 (range: 1.15–36.1) months and an OS of 4.2 (range: 1.28–38.1) months. Cox hazard-model analyses indicated significant associations between prolonged survival and gender, smoking, non-squamous histology, age below 45 years, the presence of EGFR mutations and the use of EGFR tyrosine kinase inhibitors.
Conclusion: The prognosis may be better for some patients who have reached third-line treatments, namely, young patients, females, non-smokers, and those with a non-squamous histology. In these patients, physicians should be alert in terms of driver mutations, such as EGFR mutation.

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