Open Access

ARTICLE

Tyrosine kinase inhibitors in first-line treatment of advanced NSCLC with epidermal growth factor receptor mutations: Real-world data from Vietnam

KHANH TOAN NGUYEN^*, THI HUONG PHAM, VAN LAM NGO, VAN TUAN BUI, VAN NHAT NGUYEN, THI PHUONG THAO NGUYEN, THI KHANH HA NGUYEN, THI THUY VAN NGUYEN

Department of Medical Oncology 2, Nghe An Oncology Hospital, Vinh City, 43000, Vietnam

* Corresponding Author: KHANH TOAN NGUYEN. Email:

(This article belongs to the Special Issue: Diagnosis and Treatment of Malignant Tumors of the Chest)

Oncology Research 2025, 33(7), 1667-1677. https://doi.org/10.32604/or.2025.061905

Received 05 December 2024; Accepted 17 March 2025; Issue published 26 June 2025

Abstract

Aims: The study aimed to evaluate the effectiveness and adverse events of tyrosine kinase inhibitors (TKIs) in the first-line treatment of advanced non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations. Methods: A retrospective study on advanced NSCLC patients with EGFR mutations treated with TKIs as a first-line therapy at Nghe An Oncology Hospital, Vietnam between January 2017 and August 2023. The primary endpoints included objective response rate, progression-free survival, and tolerability. The secondary endpoint was overall survival. Results: A total of 211 patients received first-line treatment with Erlotinib (n = 74), Gefitinib (n = 85), Afatinib (n = 34) or Osimertinib (n = 18). The overall response rate was 76.7%, with Osimertinib at 83.4%, Afatinib at 73.6%, Erlotinib at 77.1%, and Gefitinib at 76.5%. The median progression-free survival in the Gefitinib group was 12.2 months (95% CI: 11.1–13.2), 13.4 months (95% CI: 10.6–16.2) in the Erlotinib group, 18.4 months (95% CI: 10.1–26.8) in the Afatinib group and 25.3 months in the Osimertinib group (p = 0.001). The median overall survival was 21.8 months (95% Cl: 15.0–28.4) in the Gefitinib group, 30 months (95% Cl: 19.1–40.9) in the Erlotinib group (p = 0.154). Most drug-related adverse events were grade 1 or 2. Diarrhea was the most frequent adverse event in the Afatinib group at 44.1%; rash was most common in the Erlotinib group at 60.8%; paronychia (31.8%), and interstitial lung disease (3.5%) were most frequent in the Gefitinib group. Conclusion: The TKIs as first-line therapies for advanced NSCLC patients with EGFR mutated are highly effective, prolong survival, and are well tolerated.

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