152P - Impaired liver function was associated with PFS of EGFR TKI treatment
- Qi-Qi Zhu (CN)
- Yue-Yun Chen (CN)
- Ye Hong (CN)
- Zhen-Yu Ding (CN)
- Qi-Qi Zhu (CN)
Abstract
Background
EGFR TKI treatment revolutionized the standard of care for advanced NSCLC harboring EGFR mutation, but the surrogate markers for the efficacy need to be refined. Elevated transaminase was a dose-limiting factor for TKI treatment, while its prognostic significance was not explored before.
Methods
This was a retrospective study where pathologically confirmed NSCLC patients prescribed with first-line EGFR TKI (gefitinib, erlotinib, or icotinib) were enrolled. But those with concomitant other cancer, or target lesion resected were excluded. In addition, patients who took drugs significantly affecting liver function were excluded. The clinical data were retrieved through a pre-established database. The highest transaminase level was recorded during the treatment course. The PFS was defined as the interval between the initiation of the treatment and the date when first sign of tumor progression was significant.
Results
From Oct 2013 to Oct 2016, 208 patients were enrolled. Most of them were non-smokers (70.7%, vs smokers), had adenocarcinoma (93.3%, vs non-adeno), and took gefitinib (48.6%, vs 36.5% icotinib, vs 13.9% erlotinib). The median age was 59.5 year (range: 31–85). Female (55.8%, vs male) and exon 19 Del (54.8%, vs 38.7% L858R, vs 6.5% others) were distributed dominantly. Gefitinib was associated with the most frequent occurrence of elevated transaminase (42.5%, icotinib 26.3%, and erlotinib 32.2%), esp. ALT (40.6%, 19.7%, and 25.8% respectively). Interestingly, an inverse relationship was found between PFS and the elevated ALT. Those with elevated ALT tended to have shorter PFS (9.5 m) than those with normal ALT (12.6 m, p = 0.011, HR = 0.68). However, this correlation was not for AST (10.0 and 11.5 m respectively, p = 0.237, HR = 0.75). In Cox multivariate regression model, elevated ALT indicated shorter PFS, independent of gender, age (<60), mutation (exon19 Del or other), and smoking status.
Conclusions
Elevated ALT level but not AST level was inversely related to the PFS of TKI treatment.
Clinical trial identification
NA
Legal entity responsible for the study
N/A
Funding
Has not received any funding
Disclosure
All authors have declared no conflicts of interest.
,platelet-lymphocyteratio(plr)andadvancedlungcancerinflamationindex(ali)levelsusefulinpredictingtheoutcomesofpatientswithadvancednon-sma/thumbnails/0.png)
/thumbnails/0.png)
