Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs

Abstract Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have been the standard treatment for patients with sensitizing EGFR mutation. However, almost all patients eventually acquire resistance to EGFR-TKIs. Therefore, easily available parameters to estimate the outcome of...

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Main Authors: Yuting Li, Bicheng Wang, Shihong Fei, You Qin
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Pulmonary Medicine
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Online Access:https://doi.org/10.1186/s12890-024-03367-1
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author Yuting Li
Bicheng Wang
Shihong Fei
You Qin
author_facet Yuting Li
Bicheng Wang
Shihong Fei
You Qin
author_sort Yuting Li
collection DOAJ
description Abstract Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have been the standard treatment for patients with sensitizing EGFR mutation. However, almost all patients eventually acquire resistance to EGFR-TKIs. Therefore, easily available parameters to estimate the outcome of lung adenocarcinoma patients treated with EGFR-TKIs are in urgent need. Lung adenocarcinoma patients harbored EGFR sensitive mutant and received EGFR-TKIs as first-line or second-line treatment were recruited in the study. X-tile software were utilized to determine the optimal cut-off value of Alkaline phosphatase (ALP), direct bilirubin (DB), total bile acid (TBA), and high-density lipoprotein-cholesterol (HDL-C). The prognostic value of ALP, DB, TBA, and HDL-C for Progression-free survival (PFS) in patients were evaluated by the Kaplan-Meier curve. We applied univariate and multivariate survival analysis to identify the independent predictor for PFS in patients with EGFR-mutant advanced lung adenocarcinoma and received EGFR-TKIs. A total of 131 lung adenocarcinoma patients with a median age of 58 years old were included in the final analysis. Patients with elevated level of DB and HDL-C showed a longer PFS, while high level of ALP and TBA indicated shorter PFS in response to EGFR-TKI treatment. The multivariate survival analyses revealed a significant association of prolonged PFS with increased DB, and decreased TBA. In conclusion, these findings suggest that DB and TBA were significant independent predictors of PFS in EGFR-TKI-treated patients with advanced lung adenocarcinoma.
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spelling doaj-art-dbe1663ed75f48778633b41d79ff3c1a2024-11-24T12:09:00ZengBMCBMC Pulmonary Medicine1471-24662024-11-0124111110.1186/s12890-024-03367-1Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIsYuting Li0Bicheng Wang1Shihong Fei2You Qin3Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyCancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyAbstract Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) have been the standard treatment for patients with sensitizing EGFR mutation. However, almost all patients eventually acquire resistance to EGFR-TKIs. Therefore, easily available parameters to estimate the outcome of lung adenocarcinoma patients treated with EGFR-TKIs are in urgent need. Lung adenocarcinoma patients harbored EGFR sensitive mutant and received EGFR-TKIs as first-line or second-line treatment were recruited in the study. X-tile software were utilized to determine the optimal cut-off value of Alkaline phosphatase (ALP), direct bilirubin (DB), total bile acid (TBA), and high-density lipoprotein-cholesterol (HDL-C). The prognostic value of ALP, DB, TBA, and HDL-C for Progression-free survival (PFS) in patients were evaluated by the Kaplan-Meier curve. We applied univariate and multivariate survival analysis to identify the independent predictor for PFS in patients with EGFR-mutant advanced lung adenocarcinoma and received EGFR-TKIs. A total of 131 lung adenocarcinoma patients with a median age of 58 years old were included in the final analysis. Patients with elevated level of DB and HDL-C showed a longer PFS, while high level of ALP and TBA indicated shorter PFS in response to EGFR-TKI treatment. The multivariate survival analyses revealed a significant association of prolonged PFS with increased DB, and decreased TBA. In conclusion, these findings suggest that DB and TBA were significant independent predictors of PFS in EGFR-TKI-treated patients with advanced lung adenocarcinoma.https://doi.org/10.1186/s12890-024-03367-1Total bile acidDirect bilirubinEpidermal growth factor receptor-tyrosine kinase inhibitorProgression-free survival
spellingShingle Yuting Li
Bicheng Wang
Shihong Fei
You Qin
Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
BMC Pulmonary Medicine
Total bile acid
Direct bilirubin
Epidermal growth factor receptor-tyrosine kinase inhibitor
Progression-free survival
title Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
title_full Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
title_fullStr Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
title_full_unstemmed Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
title_short Predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with EGFR-TKIs
title_sort predictive value of direct bilirubin and total bile acid in lung adenocarcinoma patients treated with egfr tkis
topic Total bile acid
Direct bilirubin
Epidermal growth factor receptor-tyrosine kinase inhibitor
Progression-free survival
url https://doi.org/10.1186/s12890-024-03367-1
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AT shihongfei predictivevalueofdirectbilirubinandtotalbileacidinlungadenocarcinomapatientstreatedwithegfrtkis
AT youqin predictivevalueofdirectbilirubinandtotalbileacidinlungadenocarcinomapatientstreatedwithegfrtkis