Baseline predictors of early progression during EGFR-TKI therapy in patients with EGFR-mutant non-small cell lung cancer: A retrospective cohort study.

Authors

Xiaoyan Guo, Likai Liu, Hongyan Yu, Shifeng Zhao, Chunyan Wang, Xiansheng Wang

Published in

Medicine. Volume 105. Issue 31. Pages e49948. Jul 31, 2026.

Abstract

This single-center retrospective cohort study investigated baseline clinical, molecular, and treatment-related factors associated with early progression among patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer receiving EGFR tyrosine kinase inhibitors (EGFR-TKIs) between June 2022 and June 2025. Eligible patients treated during the study period were consecutively screened according to predefined eligibility criteria, and all eligible patients were included without case-control matching. Early progression was defined a priori as progressive disease within 6 months after EGFR-TKI initiation according to response evaluation criteria in solid tumors version 1.1; this cutoff was selected as a clinically meaningful landmark for early treatment failure/primary resistance and to distinguish rapid failure from patients achieving at least short-term disease control. A total of 156 patients were included (early progression, n = 52; nonearly progression, n = 104). Compared with nonearly progression, early progression was characterized by a different smoking distribution, lower body mass index, higher prevalence of chronic obstructive pulmonary disease, and greater baseline tumor burden as reflected by a higher number of target lesions, as well as higher rates of liver metastasis, bone metastasis, and pleural effusion. Molecular and treatment profiling showed higher frequencies of TP53 co-mutation and baseline EGFR T790M in early progressors, together with a higher proportion of first-generation EGFR-TKI use and more frequent receipt of EGFR-TKI as second-line or later therapy. In multivariable logistic regression, current smoking, lower body mass index, higher target lesion count, liver metastasis, bone metastasis, pleural effusion, second-line or later EGFR-TKI use, first-generation EGFR-TKI exposure, and mesenchymal-epithelial transition factor amplification were independently associated with early progression, while baseline EGFR T790M showed a borderline association. These findings support risk-adapted monitoring and molecularly informed management strategies in EGFR-mutant non-small cell lung cancer.

PMID:
42536589
Bibliographic data and abstract were imported from PubMed on 01 Aug 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.