Survival benefit of first-generation epidermal growth factor receptor–tyrosine kinase inhibitors in female with advanced lung cancer

Background: This study aimed to estimate therapeutic effects of first-generation epidermal growth factor receptor–tyrosine kinase inhibitors (EGFR-TKIs) in real-world practice, by analyzing survival outcomes in an unselected, Korean female population with advanced lung cancer based on the National Health Insurance Service database. Methods: We identified women with newly diagnosed advanced lung cancer from January 2004 to December 2013. For progression-free survival (PFS) and overall survival (OS) analyses, patients were defined into the following subgroups: group A, treated with first-generation EGFR-TKI ⩾6 months; group B, treated with EGFR-TKIs <6 months but at least >1 month; and group C, treated with cytotoxic chemotherapy as follows: monotherapy or combination therapy with gemcitabine or pemetrexed; or monotherapy with docetaxel, paclitaxel, or vinorelbine. Results: Among 11,045 enrolled patients, 6170 (55.8%) were treated with first-generation EGFR-TKIs for at least 1 month. The median OS for patients treated with EGFR-TKIs was significantly longer than that of EGFR-TKI-naive patients (19.1 months [95% confidence interval (CI) 18.5–19.7] vs 9.5 months [95% CI 9.1–9.8], P<0.001). In subgroup analysis, group A had a significantly longer median OS compared with group B (30.3 months [95% CI 29.5–31.2] vs 12.3 months [95% CI 11.9–12.7], P<0.001). The median PFS of group A was significantly longer than that of group B (15.8 vs 3.7 months, P<0.001). Conclusions: Our analysis demonstrates that EGFR-TKIs confer significant PFS and OS benefits in the real-world practice for Korean female with advanced lung cancer.