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Background <p>The role of <i>EGFR</i>-TKIs as adjuvant therapy for stage IA lung adenocarcinoma after surgery remains controversial. Though 5-year OS of stage IA patients reaches 88%, the 5-year DFSs of IA1, IA2, and IA3 vary a lot, 88.2%, 73.6% and 64.5%, respectively. This study specifically evaluated the clinical efficacy of postoperative <i>EGFR</i>-TKI therapy in stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors.</p> Methods <p>Stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors at Jinling Hospital from January 1, 2017 to December 31, 2021 were collected. Eligible patients were grouped into <i>EGFR</i>-TKI therapy group and non-<i>EGFR</i>-TKI therapy group. Subgroup analysis was performed to explore potential benefits of adjuvant <i>EGFR</i>-TKI therapy.</p> Results <p>The study cohort comprised 221 eligible patients, among which 42 patients received postoperative adjuvant <i>EGFR</i>-TKI therapy. The median duration of follow-up was 49 months(IQR: 38–63). There was no statistically significant difference in DFS between the adjuvant <i>EGFR</i>-TKI therapy group and the non-<i>EGFR</i>-TKI therapy group (<i>P</i> = 0.080). In subgroup analysis for cohorts receiving lobectomy, adjuvant <i>EGFR</i>-TKI therapy group had a better DFS than non-adjuvant <i>EGFR</i>-TKI therapy group (<i>P</i> = 0.024). Tumor size (HR = 1.071, 95%CI:1.010–1.136, <i>P</i> = 0.024) and adjuvant <i>EGFR</i>-TKI therapy (HR = 0.124, 95%CI:0.017–0.912, <i>P</i> = 0.040) were both independent significant prognostic factors for DFS in the lobectomy subgroup.</p> Conclusions <p>Generally, postoperative <i>EGFR</i>-TKI therapy might provide no significant clinical benefits for stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors. However, in specific subgroup, such as patients receiving lobectomy, <i>EGFR</i>-TKI therapy shows potential benefit which requires further exploration in the future.</p>

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Real-world efficacy of postoperative adjuvant EGFR-TKI therapy for stage IA2-IA3 lung adenocarcinoma with high-risk pathological factors

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月31日

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  • Sida Lu,
  • Chenxu Liu,
  • Heng Tao,
  • Penglong Zhao,
  • Jing Luo,
  • Zhuangzhuang Cong,
  • Yi Shen

摘要

Background

The role of EGFR-TKIs as adjuvant therapy for stage IA lung adenocarcinoma after surgery remains controversial. Though 5-year OS of stage IA patients reaches 88%, the 5-year DFSs of IA1, IA2, and IA3 vary a lot, 88.2%, 73.6% and 64.5%, respectively. This study specifically evaluated the clinical efficacy of postoperative EGFR-TKI therapy in stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors.

Methods

Stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors at Jinling Hospital from January 1, 2017 to December 31, 2021 were collected. Eligible patients were grouped into EGFR-TKI therapy group and non-EGFR-TKI therapy group. Subgroup analysis was performed to explore potential benefits of adjuvant EGFR-TKI therapy.

Results

The study cohort comprised 221 eligible patients, among which 42 patients received postoperative adjuvant EGFR-TKI therapy. The median duration of follow-up was 49 months(IQR: 38–63). There was no statistically significant difference in DFS between the adjuvant EGFR-TKI therapy group and the non-EGFR-TKI therapy group (P = 0.080). In subgroup analysis for cohorts receiving lobectomy, adjuvant EGFR-TKI therapy group had a better DFS than non-adjuvant EGFR-TKI therapy group (P = 0.024). Tumor size (HR = 1.071, 95%CI:1.010–1.136, P = 0.024) and adjuvant EGFR-TKI therapy (HR = 0.124, 95%CI:0.017–0.912, P = 0.040) were both independent significant prognostic factors for DFS in the lobectomy subgroup.

Conclusions

Generally, postoperative EGFR-TKI therapy might provide no significant clinical benefits for stage IA2-IA3 lung adenocarcinoma patients with high-risk pathological factors. However, in specific subgroup, such as patients receiving lobectomy, EGFR-TKI therapy shows potential benefit which requires further exploration in the future.