DLCO and Spirometry in non-small cell lung cancer patients receiving EGFR-TKI in Indonesia

Abstract

Abstract Introduction EGFR-TKI is the treatment of choice in non-small cell lung cancer (NSCLC) with EGFR mutation in exon 19 or 21. The influence of EGFR-TKI therapy on lung function is still unrecognizable in NSCLC patients. Objectives This prospective study aims to examine the influence of EGFR-TKI therapy on lung function of lung adenocarcinoma patients with a single mutation in EGFR exon 19 or 21 at Persahabatan National Respiratory Center Hospital Jakarta, Indonesia. The pulmonary function test (PFT), including spirometry and diffusing capacity (DLCO), was performed before and after three months of EGFR-TKI therapy. After three months, the patients were divided into groups based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria and the change of PFT was compared before and after therapy. Results Among twenty lung cancer patients enrolled, we found increase of predicted mean FVC value from 60.6% to 68.25% (p=0.03), mean predicted FEV1 value from 59.7% to 67.05% (p=0.036), mean DLCO from 11.55 ml/minute/mmHg to 13.72 ml/min/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03). The increase of mean predicted DLCO was greatest in the partial response group, which was 16.43% (p=0.056). Conclusion This study found that the majority of NSCLC patients with single EGFR exon 19 or 21 mutation had significantly improved lung function after EGFR-TKI therapy. Lung function test might become a beneficial tool to evaluate the effectiveness of EGFR-TKI in NSCLC patients, especially in clinical setting where computerized tomography (CT) scan is not available.