Cancer Res Treat.  2014 Oct;46(4):323-330. 10.4143/crt.2013.120.

Nomogram Predicting Clinical Outcomes in Non-small Cell Lung Cancer Patients Treated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors

• Keam B
• Kim DW
• Park JH
• Lee JO
• Kim TM
• Lee SH
• Chung DH
• Heo DS

• KMID: 2380369
• DOI: http://doi.org/10.4143/crt.2013.120

Abstract

PURPOSE
The aim of this study was to develop a pragmatic nomogram for prediction of progressionfree survival (PFS) for the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) in EGFR mutant non-small cell lung cancer (NSCLC).
MATERIALS AND METHODS
A total of 306 recurred or metastatic NSCLC patients with EGFR mutation, who received EGFR TKIs, were enrolled in this study. We developed the nomogram, using a Cox proportional hazard regression model for PFS.
RESULTS
The median PFS was 11.2 months. Response rate to EGFR TKI was 71.9%. Multivariate Cox model identified disease status, performance status, chemotherapy line, response to EGFR TKI, and bone metastasis as independent prognostic factors, and the nomogram for PFS was developed, based on these covariates. The concordance index for a nomogram was 0.708, and the calibration was also good.
CONCLUSION
We developed a nomogram, based on clinical characteristics, for prediction of the PFS to EGFR TKI in NSCLC patients with EGFR mutation.

Keyword

Nomograms; Lung neoplasms; Epidermal growth factor receptor; Tyrosine kinase inhibitor; Prognosis

MeSH Terms

Calibration
Carcinoma, Non-Small-Cell Lung*
Drug Therapy
Humans
Lung Neoplasms
Neoplasm Metastasis
Nomograms*
Prognosis
Protein-Tyrosine Kinases*
Receptor, Epidermal Growth Factor*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor

Figure

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  Fig. 1. Nomogram for prediction of progression-free survival (PFS) to epidermal growth factor receptor tyrosine kinase inhibitor (TKI) in non-small cell lung cancer. The nomogram is used by totaling the points identified on the top scale for each independent covariate. The total points projected to the bottom scale indicate the % probability of 6-, 12-, and 18-month PFS. ECOG PS, Eastern Cooperative Oncology Group performance status.

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  Fig. 2. Receiver operating characteristic curve of the Cox proportional hazard regression model. Harrell’s C-index was 0.708 (95% confidence interval, 0.659 to 0.758).

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  Fig. 3. Calibration plot for 12-month progression-free survival (PFS) from the nomogram. On the calibration plot, the x-axis is nomogram predicted probability of PFS. The y-axis is observed PFS. Vertical bars indicate 95% confidence interval calculated using Kaplan-Meier analysis.

Reference

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