دورية أكاديمية
أعرض في EDS

Assessment of Tyrosine Kinase Inhibitors and Survival and Cardiovascular Outcomes of Patients With Non-Small Cell Lung Cancer in Taiwan.

التفاصيل البيبلوغرافية
العنوان: Assessment of Tyrosine Kinase Inhibitors and Survival and Cardiovascular Outcomes of Patients With Non-Small Cell Lung Cancer in Taiwan.
المؤلفون: Chang WT; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan.; Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan., Lin HW; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Chang TC; Division of Pulmonology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan., Lin SH; Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan., Li YH; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
المصدر: JAMA network open [JAMA Netw Open] 2023 May 01; Vol. 6 (5), pp. e2313824. Date of Electronic Publication: 2023 May 01.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Carcinoma, Non-Small-Cell Lung*/drug therapy , Carcinoma, Non-Small-Cell Lung*/epidemiology , Carcinoma, Non-Small-Cell Lung*/chemically induced , Lung Neoplasms*/drug therapy , Lung Neoplasms*/epidemiology, Humans ; Female ; Child ; Male ; Tyrosine Kinase Inhibitors ; Cohort Studies ; Taiwan/epidemiology ; Protein Kinase Inhibitors/therapeutic use ; ErbB Receptors
مستخلص: Importance: Tyrosine kinase inhibitors (TKIs) have been recognized as the standard treatment for patients with non-small cell lung cancers (NSCLCs) and epidermal growth factor receptor (EGFR) sequence variation. Although TKIs have been reported to cause cardiotoxicity, they are widely administered owing to the high prevalence of EGFR sequence variation in Taiwan.
Objective: To compare the outcomes of death and major adverse cardiac and cerebrovascular events among patients with NSCLC who use and do not use TKIs in a national cohort.
Design, Setting, and Participants: Using data from the Taiwanese National Health Insurance Research Database and National Cancer Registry, patients treated for NSCLC from 2011 to 2018 were identified, and their outcomes were analyzed, including death and major adverse cardiac and cerebrovascular events (MACCEs; such as heart failure, acute myocardial infarction, and ischemic stroke) after adjusting for age, sex, cancer stage, comorbidities, anticancer therapies, and cardiovascular drugs. The median follow-up duration was 1.45 years. The analyses were performed from September 2022 to March 2023.
Exposures: TKIs.
Main Outcomes and Measures: Cox proportional hazards models were used to estimate death and MACCEs in patients treated with and without TKIs. Given that death may reduce the incidence of cardiovascular events, the competing risk method was used to calculate the MACCE risk after adjustment for all potential confounders.
Results: Overall, 24 129 patients treated with TKIs were matched with 24 129 patients who did not receive TKIs (24 215 [50.18%] were female; and the mean [SD] age was 66.93 [12.37] years). Compared with those not receiving TKIs, the TKI group presented with a significantly lower hazard ratio (HR) of all-cause death (adjusted HR, 0.76; 95% CI, 0.75-0.78; P < .001), and the reason for death was primarily cancer. In contrast, the HR of MACCEs significantly increased (subdistribution HR, 1.22; 95% CI, 1.16-1.29; P < .001) in the TKI group. Furthermore, afatinib use was associated with a significantly reduced risk of death among patients receiving various TKIs (adjusted HR, 0.90; 95% CI, 0.85-0.94; P < .001) compared with those receiving erlotinib and gefitinib, although the outcomes of MACCEs were similar between the 2 groups.
Conclusions and Relevance: In this cohort study of patients with NSCLC, TKI use was associated with reduced HRs of cancer-related death but increased HRs of MACCEs. These findings suggest the importance of close monitoring of cardiovascular problems in individuals receiving TKIs.
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المشرفين على المادة: 0 (Tyrosine Kinase Inhibitors)
0 (Protein Kinase Inhibitors)
EC 2.7.10.1 (ErbB Receptors)
تواريخ الأحداث: Date Created: 20230517 Date Completed: 20230519 Latest Revision: 20231213
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10193184
DOI: 10.1001/jamanetworkopen.2023.13824
PMID: 37195663
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2023.13824