Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer

Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This...

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Main Authors: Agus Andreas Santoso, Suryanti Dwi Pratiwi, Yani Jane Sugiri, Harun Al Rasyid, Aditya Sri Listyoko
Format: Article
Language:English
Published: Universitas Airlangga 2025-05-01
Series:Jurnal Respirasi
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Online Access:https://e-journal.unair.ac.id/JR/article/view/68755
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author Agus Andreas Santoso
Suryanti Dwi Pratiwi
Yani Jane Sugiri
Harun Al Rasyid
Aditya Sri Listyoko
author_facet Agus Andreas Santoso
Suryanti Dwi Pratiwi
Yani Jane Sugiri
Harun Al Rasyid
Aditya Sri Listyoko
author_sort Agus Andreas Santoso
collection DOAJ
description Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.
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spelling doaj-art-86b76129c49f4b49bc1447a2bcf03cfd2025-08-20T03:25:59ZengUniversitas AirlanggaJurnal Respirasi2407-08312621-83722025-05-01112140146https://doi.org/10.20473/jr.v11-I.2.2025.140-146Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung CancerAgus Andreas Santoso0https://orcid.org/0009-0007-6789-962XSuryanti Dwi Pratiwi1https://orcid.org/0000-0002-4733-7837Yani Jane Sugiri2https://orcid.org/0000-0001-9221-6463Harun Al Rasyid3https://orcid.org/0000-0002-1345-9668Aditya Sri Listyoko4https://orcid.org/0000-0002-6811-7163Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.Doctoral Student, Division of Respiratory Medicine and Rheumatology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan.Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.https://e-journal.unair.ac.id/JR/article/view/68755carcinoembryonic antigen (cea)egfr-tkinsclcoverall survival (os)progression-free survival (pfs)
spellingShingle Agus Andreas Santoso
Suryanti Dwi Pratiwi
Yani Jane Sugiri
Harun Al Rasyid
Aditya Sri Listyoko
Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
Jurnal Respirasi
carcinoembryonic antigen (cea)
egfr-tki
nsclc
overall survival (os)
progression-free survival (pfs)
title Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
title_full Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
title_fullStr Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
title_full_unstemmed Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
title_short Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer
title_sort prognosis of tyrosine kinase inhibitor therapy for non small cell lung cancer
topic carcinoembryonic antigen (cea)
egfr-tki
nsclc
overall survival (os)
progression-free survival (pfs)
url https://e-journal.unair.ac.id/JR/article/view/68755
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