Clinical features and outcomes of first-line EGFR-TKI treatment in younger and older patients with EGFR-mutated NSCLC

Yi-Chun Lai; Cheng-Yu Chang; Yu-Feng Wei; Chung-Yu Chen; Shih-Chieh Chang

doi:10.1080/14796694.2025.2514422

Clinical features and outcomes of first-line EGFR-TKI treatment in younger and older patients with EGFR-mutated NSCLC

Future Oncol. 2025 Jun 8:1-12. doi: 10.1080/14796694.2025.2514422. Online ahead of print.

Authors

Yi-Chun Lai^{1

2}, Cheng-Yu Chang^{3

4}, Yu-Feng Wei^{5

6}, Chung-Yu Chen^{7

8}, Shih-Chieh Chang^{1

2

9}

Affiliations

¹ Division of Chest Medicine, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yi-Lan, Taiwan.
² Faculty of Medicine, College of Medicine, National Yang-Ming Chiao Tung University, Taipei, Taiwan.
³ Division of Chest Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
⁴ Nursing Department, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan.
⁵ Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan.
⁶ School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁷ Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan.
⁸ College of Medicine, National Taiwan University, Taipei, Taiwan.
⁹ Department of Critical Care Medicine, National Yang-Ming Chiao Tung University Hospital, Yi-Lan, Taiwan.

PMID: 40483636
DOI: 10.1080/14796694.2025.2514422

Abstract

Background: The clinical characteristics and outcomes of younger versus older patients with EGFR-mutated advanced NSCLC undergoing first-line EGFR-TKI treatment remain underexplored.

Methods: This multicenter, retrospective study analyzed patients treated between 2010 and 2019. Univariate and multivariate analyses identified factors associated with outcomes.

Results: Among 235 patients, 38 were under 50 years and 197 over 65 years. Median progression-free survival (PFS) was 21.1 months in younger patients and 15.6 months in older patients (p = 0.095). Median overall survival (OS) was 40.0 months in the young group and 23.2 months in the elderly group (p = 0.008). Afatinib or erlotinib was linked to longer OS in younger patients. In elderly patients, better ECOG performance status and body mass index over 18.5 were significantly associated with improved OS.

Conclusion: Younger patients receiving afatinib or erlotinib showed better outcomes. For older patients, clinical factors such as functional status and body weight strongly influenced survival.

Keywords: ECOG performance status; EGFR; NSCLC; TKI; Taiwan; afatinib and erlotinib; multicenter study; young age.