The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia

Introduction: Targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment for non-small cell lung cancer (NSCLC). However, drug resistance has grown in the last few decades. This study compared the progression time of lung cancer...

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Main Authors: Elisna Syahruddin, Noni Novisari Soeroso, Fannie Rizki Ananda, Laksmi Wulandari, Ana Rima Setijadi, Sabrina Ermayanti, Suryanti Dwi Pratiwi, Andreas Infianto, Novita Andayani, Sri Melati Munir, Avissena Dutha Pratama, Ida Ayu Jasminarti Dwi Kusumawardani, Haryati Haryati, Natalie Duyen, Muhammad Alfin Hanif, Darren Wan-Teck Lim
Format: Article
Language:English
Published: Universitas Airlangga 2025-01-01
Series:Jurnal Respirasi
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Online Access:https://e-journal.unair.ac.id/JR/article/view/64531
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author Elisna Syahruddin
Noni Novisari Soeroso
Fannie Rizki Ananda
Laksmi Wulandari
Ana Rima Setijadi
Sabrina Ermayanti
Suryanti Dwi Pratiwi
Andreas Infianto
Novita Andayani
Sri Melati Munir
Avissena Dutha Pratama
Ida Ayu Jasminarti Dwi Kusumawardani
Haryati Haryati
Natalie Duyen
Muhammad Alfin Hanif
Darren Wan-Teck Lim
author_facet Elisna Syahruddin
Noni Novisari Soeroso
Fannie Rizki Ananda
Laksmi Wulandari
Ana Rima Setijadi
Sabrina Ermayanti
Suryanti Dwi Pratiwi
Andreas Infianto
Novita Andayani
Sri Melati Munir
Avissena Dutha Pratama
Ida Ayu Jasminarti Dwi Kusumawardani
Haryati Haryati
Natalie Duyen
Muhammad Alfin Hanif
Darren Wan-Teck Lim
author_sort Elisna Syahruddin
collection DOAJ
description Introduction: Targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment for non-small cell lung cancer (NSCLC). However, drug resistance has grown in the last few decades. This study compared the progression time of lung cancer patients treated with first- and second-generation EGFR-TKI. Methods: Based on cytology and histological results, this cross-sectional study included 1,008 participants diagnosed with lung adenocarcinoma (LUAD) from 11 Indonesian Respiratory Centers. Every three months, the response to treatment was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) criteria in 1.1. Significant differences in the clinical features of the three TKI treatment groups were identified using logistic regression analysis, the median time to disease progression was estimated using the Kaplan-Meier technique, and independent prognostic factors related to the time to progression (TTP) were assessed using Cox proportional hazards regression. Results: This study examined 505 patients, the majority of whom were females (50.9%), never smoked (59.8%), diagnosed at an advanced stage (99.2%), and had an Eastern Cooperative Oncology Group (ECOG) scale of 0-1 (83.2%). Approximately 98.1% of patients were treated with afatinib (14.8%), erlotinib (18.6%), and gefitinib (66.1%) due to common mutations. The groups did not differ significantly (p>0.05). The median overall survival (OS) rate was 9 months. The time to LUAD progression in lung cancer was significantly impacted by poor performance (p=0.001). Conclusion: Epidermal growth factor receptor-tyrosine kinase inhibitor treatment can only prolong the TTP of LUAD by up to 9 months, and the performance scale when receiving the EGFR-TKI significantly affects the prognosis.
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spelling doaj-art-716d10eaa10b42509052d79b98c8a2912025-08-20T02:45:43ZengUniversitas AirlanggaJurnal Respirasi2407-08312621-83722025-01-011112230https://doi.org/10.20473/jr.v11-I.1.2025.22-30The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in IndonesiaElisna Syahruddin0https://orcid.org/0000-0002-4383-2240Noni Novisari Soeroso1https://orcid.org/0000-0002-2687-4924Fannie Rizki Ananda2https://orcid.org/0000-0002-5982-2194Laksmi Wulandari3https://orcid.org/0000-0002-5000-0151Ana Rima Setijadi4https://orcid.org/0000-0001-7848-9588Sabrina Ermayanti5https://orcid.org/0000-0002-2956-9845Suryanti Dwi Pratiwi6https://orcid.org/0000-0002-4733-7837Andreas Infianto7https://orcid.org/0009-0001-5800-3322Novita Andayani8https://orcid.org/0009-0006-6032-8296Sri Melati Munir9https://orcid.org/0000-0002-5274-8980Avissena Dutha Pratama10https://orcid.org/0009-0008-8860-9502Ida Ayu Jasminarti Dwi Kusumawardani11https://orcid.org/0000-0002-2716-5222Haryati Haryati12https://orcid.org/0000-0001-8605-9991Natalie Duyen13https://orcid.org/0009-0000-3939-2476Muhammad Alfin Hanif14https://orcid.org/0000-0003-4303-8239Darren Wan-Teck Lim15https://orcid.org/0000-0002-4655-0206Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Andalas, Padang, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Lampung, Bandar Lampung, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Syiah Kuala, Aceh, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Riau, Pekanbaru, Indonesia.Division of Pulmonary Disease and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Udayana, Denpasar, Indonesia.Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarmasin, Indonesia.Division of Pulmonology, Department of Internal Medicine, Faculty of Medicine Universitas Sriwijaya, Palembang, Indonesia.Department of Pulmonology, Dharmais National Cancer Center Hospital, Jakarta, Indonesia.Division of Medical Oncology, National Cancer Centre Singapore/Duke-NUS Medical School, Singapore.Introduction: Targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment for non-small cell lung cancer (NSCLC). However, drug resistance has grown in the last few decades. This study compared the progression time of lung cancer patients treated with first- and second-generation EGFR-TKI. Methods: Based on cytology and histological results, this cross-sectional study included 1,008 participants diagnosed with lung adenocarcinoma (LUAD) from 11 Indonesian Respiratory Centers. Every three months, the response to treatment was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) criteria in 1.1. Significant differences in the clinical features of the three TKI treatment groups were identified using logistic regression analysis, the median time to disease progression was estimated using the Kaplan-Meier technique, and independent prognostic factors related to the time to progression (TTP) were assessed using Cox proportional hazards regression. Results: This study examined 505 patients, the majority of whom were females (50.9%), never smoked (59.8%), diagnosed at an advanced stage (99.2%), and had an Eastern Cooperative Oncology Group (ECOG) scale of 0-1 (83.2%). Approximately 98.1% of patients were treated with afatinib (14.8%), erlotinib (18.6%), and gefitinib (66.1%) due to common mutations. The groups did not differ significantly (p>0.05). The median overall survival (OS) rate was 9 months. The time to LUAD progression in lung cancer was significantly impacted by poor performance (p=0.001). Conclusion: Epidermal growth factor receptor-tyrosine kinase inhibitor treatment can only prolong the TTP of LUAD by up to 9 months, and the performance scale when receiving the EGFR-TKI significantly affects the prognosis.https://e-journal.unair.ac.id/JR/article/view/64531canceregfr-tkilung adenocarcinomaprogression-free survivaltime to progression
spellingShingle Elisna Syahruddin
Noni Novisari Soeroso
Fannie Rizki Ananda
Laksmi Wulandari
Ana Rima Setijadi
Sabrina Ermayanti
Suryanti Dwi Pratiwi
Andreas Infianto
Novita Andayani
Sri Melati Munir
Avissena Dutha Pratama
Ida Ayu Jasminarti Dwi Kusumawardani
Haryati Haryati
Natalie Duyen
Muhammad Alfin Hanif
Darren Wan-Teck Lim
The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
Jurnal Respirasi
cancer
egfr-tki
lung adenocarcinoma
progression-free survival
time to progression
title The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
title_full The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
title_fullStr The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
title_full_unstemmed The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
title_short The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia
title_sort time to progression in lung adenocarcinoma patients receiving first and second generation egfr tki in indonesia
topic cancer
egfr-tki
lung adenocarcinoma
progression-free survival
time to progression
url https://e-journal.unair.ac.id/JR/article/view/64531
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