EVALUATING THE EFFECTIVENESS OF TARGETED LUNG CANCERTHERAPY IN THE TURKESTAN REGION FOR 2019-2022

Abstract

Introduction: The treatment of patients with lung cancer is one of the urgent problems of modern medicine. The
detection of a mutation in the epidermal growth factor receptor gene (EGFR-Epidermal Growth Factor Receptor) is an
important step in the treatment of widespread non-small cell lung cancer, since this approach consists in the fact that the use
of specially developed targeted therapy drugs is clinically effective and allows you to identify a special group of patients.
Research by scientists shows that the use of targeted therapy drugs in patients with disseminated non-small cell lung cancer
and the presence of an EGFR mutation is clinically effective, as it leads to a significant increase in the frequency of objective
effects and improved progression-free survival, compared with the results of chemotherapy.
Цель исследования. Evaluation of the effectiveness of targeted lung cancer therapy in the Turkestan region for 2019-2022.
Materials and methods: A retrospective statistical study of treatment results was conducted using the Kaplan-Meyer survival
analysis and RECIST criteria. Patients were randomized (1:1) using a minimization procedure and stratified according to the type of
EGFR mutation. The primary result was progression-free survival, analyzed in patients with confirmed disease who received at least
a few doses of the investigational drug. During the study period, 96 patients with lung cancer with EGFR mutation were considered
in the Turkestan region, 48 of them received targeted therapy (afatinib – 28 (58%) patients, erlotinib – 11 (58%) patients, osimertinib
– 9 (58%) patients), and the remaining 48 received chemotherapy. The analyzed indicators were: patient's age, gender, histological
data, diagnosis, stages, types of treatment. All statistical calculations were performed using the SPSS program (version 25.0, IBM
SPSS Inc., Chicago, USA). The data were summarized using descriptive statistics methods.
Results: Thus, the median progression–free survival with afatanib is 12.6 months, with chemotherapy - 5.8 months. In
patients taking afatinib, progression is observed 0.266.67 times less frequently than in patients receiving chemotherapy,
since the confidence interval does not contain 1, the relationship between taking afatinib and the time of onset of progression
is statistically significant (p<0.05). That is, the median progression-free survival was significantly higher in patients receiving
erlotinib than in patients receiving chemotherapy (12.6 vs. 5.8 months; HR=0.26667, 95% CI 0.10088–0.703733; p< 0.05).
The median progression–free survival with erlotinib is 13.8 months, with chemotherapy - 4.8 months.In patients receiving
erlotinib, progression is 0.2223 times less frequent than in patients receiving chemotherapy, then the relationship between taking
erlotinib and the time of onset of progression is statistically significant (p<0.05). That is, the median progression-free survival
was significantly higher in patients receiving erlotinib than in patients receiving chemotherapy (13.8 versus 5.8 months;
HR=0.22223, 95% CI 0.187457–0.932733; p< 0.05). The median progression–free survival with osimertinib is 10 months, with
chemotherapy - 4.6 months. In patients taking the drug osimertinib, progression is observed 0.42857 times less frequently than
in patients receiving chemotherapy, the relationship between taking osimertinib and the time of onset of progression is
statistically significant (p<0.05). That is, the median progression-free survival was significantly higher in patients receiving
osimertinib than in patients receiving chemotherapy (10 vs. 4.6 months; HR=0.42857, 95% CI 0.161232–0.737965; p< 0,05).
Conclusion: The effectiveness of targeted lung cancer therapy in the Turkestan region for 2019-2022 was evaluated for
the first time. The progression of the process was observed in 6 (13%) patients receiving targeted therapy, stabilization of the
process was observed in 33 (68%) patients, and partial regression was observed in 9 (19%) patients. The stabilization of the
process was 68%, that is, it lasted for more than 12 months. It should be noted that, compared with standard chemotherapy,
targeted therapy provided a significant improvement in progression-free survival in patients with advanced non-small cell
lung cancer with an EGFR mutation and was associated with more favorable tolerability.