Efficacy of First-Line EGFR-TKI Treatment in Octogenarians with Lung Adenocarcinoma and Common EGFR Mutations.

OBJECTIVE: This retrospective cohort study compared the efficacy and tolerability of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) between octogenarians (aged ≥80 years) and non-octogenarians with advanced EGFR-mutated lung adenocarcinoma. METHODS: We retrospectively analyzed 151 patients with advanced lung adenocarcinoma harboring common EGFR exon 19 deletions or exon 21 L858R mutations who received first-line EGFR-TKI therapy. Patient characteristics, treatment outcomes, and adverse events were evaluated. RESULTS: Progression-free survival (PFS) did not differ significantly between octogenarians and non-octogenarians. Overall survival (OS) was shorter in octogenarians, which may be partly explained by lower rates of subsequent therapy and age-related clinical factors. No significant differences in treatment-related toxicities were observed between the two groups. CONCLUSION: This study provides clinically relevant real-world evidence supporting the feasibility of first-line EGFR-TKI therapy in octogenarians with EGFR-mutated lung adenocarcinoma. Chronological age alone should not preclude carefully selected very elderly patients from receiving EGFR-TKI treatment.