Effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor combined with chemotherapy on progression-free survival in advanced non-small cell lung cancer patients with epidermal growth factor receptor mutation

Objective To explore the effects of individual or combination medication of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) combined with chemotherapy on progression-free survival (PFS) in advanced non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutation.

Methods A total of 110 advanced NSCLC patients with EGFR mutation in our hospital from January 2019 to April 2021 were selected as research objects. According to different therapeutic plans, they were divided into group A with 37 cases (anlotinib chemotherapy), group B with 32 cases (icotinib chemotherapy) and group C with 41 cases (anlotinib plus icotinib and chemotherapy). The short-term effect, levels of vascular growth factors before and after treatment, and the incidence of adverse reactions were compared among the three groups. After 2 years of follow-up, survival curve was drawn by Kaplan-Meier method, and survival rate and PFS were compared in three groups by Log-rank.

Results The objective response rate (ORR) was 68.29% in the group C, which was significantly higher than 43.24% in the group A and 40.62% in the group B (P < 0.05); after treatment, levels of serum vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and platelet-derived growth factor (PDGF) in the group C were significantly lower than those in the group A and the group B (P < 0.05); the total incidence of adverse reactions was 29.27% in the group C, which showed no significant differences when compared to 24.32% in the group A and 25.00% in the group B (P>0.05). By the time of the last follow-up, the 2-year overall survival rate was 74.29% in the group C, which was significantly higher than 51.09% in the group A and 45.03% in the group B (Log-rank χ²=6.478, P=0.039); the median PFS in the group A, the group B and the group C was 9.0, 8.6 and 13.2 months respectively, and differences were statistically significant (Log-rank χ²=6.264, P=0.043).

Conclusion For the advanced NSCLC patients with EGFR mutations, combination medication of EGFR-TKI combined with chemotherapy can effectively increase ORR, reduce levels of serum vascular growth factors, prolong the PFS, and the safety is good.