TY - JOUR
T1 - Key prognostic factors for EGFR-mutated non-adenocarcinoma lung cancer patients in the Japanese Joint Committee of Lung Cancer Registry Database
AU - Kobayashi, Keigo
AU - Soejima, Kenzo
AU - Fukunaga, Koichi
AU - Shintani, Yasushi
AU - Sekine, Ikuo
AU - Shukuya, Takehito
AU - Takayama, Koichi
AU - Inoue, Akira
AU - Okamoto, Isamu
AU - Kiura, Katsuyuki
AU - Takahashi, Kazuhisa
AU - Yamamoto, Nobuyuki
AU - Takiguchi, Yuichi
AU - Miyaoka, Etsuo
AU - Okumura, Meinoshin
AU - Yoshino, Ichiro
N1 - Funding Information:
The authors wish to thank all the contributors at the participating institutions. The Japanese Joint Committee of Lung Cancer Registry and this study were supported by The Japan Lung Cancer Society, The Japanese Respiratory Society, and The Japan Society for Respiratory Endoscopy. We would like to thank Editage (www.editage.com) for English language editing.
Funding Information:
The authors wish to thank all the contributors at the participating institutions. The Japanese Joint Committee of Lung Cancer Registry and this study were supported by The Japan Lung Cancer Society , The Japanese Respiratory Society , and The Japan Society for Respiratory Endoscopy . We would like to thank Editage ( www.editage.com ) for English language editing.
Publisher Copyright:
© 2020 Elsevier B.V.
PY - 2020/8
Y1 - 2020/8
N2 - Introduction: The efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) for EGFR-mutated non-adenocarcinoma (ADC) non-small cell lung cancer patients is not well established. Herein, we investigated key prognostic factors influencing the efficacy of EGFR-TKIs in these patients. Methods: A total of 12,320 lung cancer patients pathologically diagnosed in 2012 at teaching hospitals in Japan were retrospectively selected. The follow-up survey was closed in 2016. Results: EGFR-mutated non-ADC patients were more prone to malignant pleural effusion (MPE) and distant metastasis than ADC patients (P = 0.071 and 0.022, respectively). EGFR-mutated ADC patients were likely to have a longer median overall survival (OS) than non-ADC patients [hazard ratio (HR) 1.3 (95 % CI, 0.97–1.8, P = 0.072)—29.5 months (95 % CI, 27.9–31.1 months) versus 19.5 months (95 % CI, 10.8–28.2 months) (P = 0.068)]. There was no significant difference in median OS between EGFR-positive ADC and non-ADC patients receiving treatment with first-generation EGFR-TKI. Among EGFR-positive non-ADC patients, the median OS was significantly longer for patients receiving EGFR-TKI treatment than for those who did not [HR 4.5 (95 % CI, 2.1–9.8, P < 0.001)—25.5 months (95 % CI, 8.1–42.9 months) versus 7.5 months (95 % CI, 3.4–11.6 months) (P < 0.001)]. While there was no significant difference in the median OS for ADC patients with either 19 del or L858R mutations, the median OS was significantly longer for EGFR-mutated non-ADC patients with 19 del than for those with L858R mutation (HR 3.2 [95 % CI, 1.5–6.9, P = 0.004]; it was not reached for 19 del and was 15.5 months for L858R [95 % CI, 6.6–24.4 months], P = 0.002). Discussion: EGFR-mutated non-ADC patients were more prone to MPE and distant metastasis. Both ADC and EGFR del19-positive non-ADC patients can benefit from EGFR-TKI treatment, whereas EGFR L858R-positive non-ADC patients might require different therapeutic options.
AB - Introduction: The efficacy of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) for EGFR-mutated non-adenocarcinoma (ADC) non-small cell lung cancer patients is not well established. Herein, we investigated key prognostic factors influencing the efficacy of EGFR-TKIs in these patients. Methods: A total of 12,320 lung cancer patients pathologically diagnosed in 2012 at teaching hospitals in Japan were retrospectively selected. The follow-up survey was closed in 2016. Results: EGFR-mutated non-ADC patients were more prone to malignant pleural effusion (MPE) and distant metastasis than ADC patients (P = 0.071 and 0.022, respectively). EGFR-mutated ADC patients were likely to have a longer median overall survival (OS) than non-ADC patients [hazard ratio (HR) 1.3 (95 % CI, 0.97–1.8, P = 0.072)—29.5 months (95 % CI, 27.9–31.1 months) versus 19.5 months (95 % CI, 10.8–28.2 months) (P = 0.068)]. There was no significant difference in median OS between EGFR-positive ADC and non-ADC patients receiving treatment with first-generation EGFR-TKI. Among EGFR-positive non-ADC patients, the median OS was significantly longer for patients receiving EGFR-TKI treatment than for those who did not [HR 4.5 (95 % CI, 2.1–9.8, P < 0.001)—25.5 months (95 % CI, 8.1–42.9 months) versus 7.5 months (95 % CI, 3.4–11.6 months) (P < 0.001)]. While there was no significant difference in the median OS for ADC patients with either 19 del or L858R mutations, the median OS was significantly longer for EGFR-mutated non-ADC patients with 19 del than for those with L858R mutation (HR 3.2 [95 % CI, 1.5–6.9, P = 0.004]; it was not reached for 19 del and was 15.5 months for L858R [95 % CI, 6.6–24.4 months], P = 0.002). Discussion: EGFR-mutated non-ADC patients were more prone to MPE and distant metastasis. Both ADC and EGFR del19-positive non-ADC patients can benefit from EGFR-TKI treatment, whereas EGFR L858R-positive non-ADC patients might require different therapeutic options.
KW - EGFR mutation
KW - EGFR-TKI
KW - Lung cancer registry
KW - Non-adenocarcinoma
KW - Prognostic factor
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U2 - 10.1016/j.lungcan.2020.06.015
DO - 10.1016/j.lungcan.2020.06.015
M3 - Article
C2 - 32590236
AN - SCOPUS:85086736187
SN - 0169-5002
VL - 146
SP - 236
EP - 243
JO - Lung Cancer
JF - Lung Cancer
ER -
