Otto Manninen, Sanna Iivanainen, Martti Arffman, Jussi Pekka Koivunen
{"title":"Non-small cell lung cancer treated with epidermal growth factor receptor inhibitors: the effect of concurrent medications on patient outcomes.","authors":"Otto Manninen, Sanna Iivanainen, Martti Arffman, Jussi Pekka Koivunen","doi":"10.1159/000543163","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>EGFR tyrosine kinase inhibitor (TKI)-induced rash can be alleviated with tetracyclines (TCN) and topical corticosteroids (TCS), whereas drugs for acid-related disorders (DARD) can affect EGFR TKI absorption. The present study investigated the concomitant use of TCNs, TCSs, and DARDs with EGFR-TKIs in non-small cell lung cancer (NSCLC) and whether these affect patient outcomes.</p><p><strong>Methods: </strong>We retrospectively collected data from all patients (n=1498) who had purchased for EGFR TKIs (erlotinib, gefitinib, and afatinib) in Finland between 2011-2020. Overall survival (OS) and time on treatment (ToT) were analyzed from the first EGFR TKI purchase.</p><p><strong>Results: </strong>Early TCN purchases were registered in 298 (19.6%) patients; early TCS and DARD purchases were observed in 154 (10.1%) and 192 (12.9%) while similar percentages were detected in the EGFR mutant cohort. In the entire cohort, early purchase of TCSs and TCNs was associated with improved ToT, OS, and DARDs with inferior outcomes. In the multivariate analysis, TCSs retained their significance in ToT (HR, 0.78; 95% 0.66-0.94), TCNs in OS (HR, 0.73; 95% 0.63-0.84), and DARDs in both (HR, 1.28; 95% 1.091-1.495; HR, 1.19; 95% 1.01-1.41). In the EGFR mutant cohort, similar non-significant trends were observed for TCSs and DARDs. In the analysis according to EGFR TKI, erlotinib users had improved outcomes when early TCN or TCS purchases were registered, whereas DARDs were associated with worse outcomes among gefitinib users.</p><p><strong>Conclusions: </strong>Among EGFR-TKI-treated NSCLCs, the use of TCN, TCS, and DARD can affect treatment outcomes that should be considered in optimal patient care.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-18"},"PeriodicalIF":2.5000,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000543163","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: EGFR tyrosine kinase inhibitor (TKI)-induced rash can be alleviated with tetracyclines (TCN) and topical corticosteroids (TCS), whereas drugs for acid-related disorders (DARD) can affect EGFR TKI absorption. The present study investigated the concomitant use of TCNs, TCSs, and DARDs with EGFR-TKIs in non-small cell lung cancer (NSCLC) and whether these affect patient outcomes.
Methods: We retrospectively collected data from all patients (n=1498) who had purchased for EGFR TKIs (erlotinib, gefitinib, and afatinib) in Finland between 2011-2020. Overall survival (OS) and time on treatment (ToT) were analyzed from the first EGFR TKI purchase.
Results: Early TCN purchases were registered in 298 (19.6%) patients; early TCS and DARD purchases were observed in 154 (10.1%) and 192 (12.9%) while similar percentages were detected in the EGFR mutant cohort. In the entire cohort, early purchase of TCSs and TCNs was associated with improved ToT, OS, and DARDs with inferior outcomes. In the multivariate analysis, TCSs retained their significance in ToT (HR, 0.78; 95% 0.66-0.94), TCNs in OS (HR, 0.73; 95% 0.63-0.84), and DARDs in both (HR, 1.28; 95% 1.091-1.495; HR, 1.19; 95% 1.01-1.41). In the EGFR mutant cohort, similar non-significant trends were observed for TCSs and DARDs. In the analysis according to EGFR TKI, erlotinib users had improved outcomes when early TCN or TCS purchases were registered, whereas DARDs were associated with worse outcomes among gefitinib users.
Conclusions: Among EGFR-TKI-treated NSCLCs, the use of TCN, TCS, and DARD can affect treatment outcomes that should be considered in optimal patient care.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
