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Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer Santoso, Agus Andreas; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane; Al Rasyid, Harun; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.140-146

Abstract

Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.
Sarcomatoid Carcinoma Of The Mediastinal : A Rare Case of Giant Mass Thymic Carcinoma Subtype Santoso, Agus Andreas; Parsama Putra, Ngakan Putu; Setiawan, Ungky Agus; Isharanto, Artono; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (12695.27 KB) | DOI: 10.21776/ub.mrj.2021.003.01.4

Abstract

ABSTRACTTitle: Sarcomatoid Carcinoma Of The Mediastinum: A Rare Case of Giant Mass Thymic Carcinoma SubtypeAuthor: Agus Andreas Santoso, MD. Pulmonology and Respiratory Medicine Department, Brawijaya University, Malang, Indonesia. Supervisor: Ngakan Putu Persama Putra, MD, Pulmonologist Consultant, Ungky Agus Setiawan, MD, Pulmonologist Consultant, Artono I, MD, Cardiovascular and Thorax Surgeon, Dini Rachma Erawati, MD, Radiologist Consultant, Hendy Setyo Yudhanto, MD, Pathology Anatomy Specialist.Introduction: Sarcomatoid carcinoma is a type of thymus carcinoma that contains partial or complete spindle cells. Incidence of Sarcomatoid Carcinoma 5-10% of all patients with thymic carcinoma. Carcinoma Sarcomatoid is a highly progressive tumor, most patients will die after 3 years of diagnosis despite aggressive multimodality therapy.Case Description: A 47-year-old woman with chest pain, shortness of breath, coughing, weight loss, enlarging lump in the neck and chest was felt for 1 month. Physical and supporting examination showed anterior superior mediastinal tumors and soft mass tissue in the right region of the Colli. Based on the Transthoracal FNAB Guiding ultrasound and FNAB the anterior colli region concluded that Thymoma, thyroid oncocytic adenoma and Nodular colloid goiter with azkanasy cell proliferation. The patient had Partial Sternotomy (Hemiclamshell), thymectomy with the final diagnosis of Sarcomatoid Carcinoma. Discussion: Sarcomatoid carcinoma is a type of thymic carcinoma that has both malignant epithelium (carcinomatous) and spindle cells (sarcomatous/sarcomatoid), generally with a transition between the two. This case was interesting because of the rare occurrence of Sarcomatoid Carcinoma plus the large size of tumor mass in this patient.Â