Characteristics of Long-Term Survivors With EGFR-Mutant Metastatic NSCLC

IF 3 Q2 ONCOLOGY
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Abstract

Introduction

Characteristics of long-term survivors in EGFR-mutant (EGFRm) NSCLC are not fully understood. This retrospective analysis evaluated a multi-institution cohort of patients with EGFRm NSCLC treated in the pre-osimertinib era and sought to describe characteristics of long-term survivors.

Methods

Clinical characteristics and outcomes were abstracted from the electronic medical records of patients with EGFRm metastatic NSCLC who started first-line therapy before 2015. Demographics and comutations were compared between greater than or equal to 5-year survivors and less than 5-year survivors. Multivariable Cox proportional hazard and logistic regression models were used to evaluate factors associated with survival and the odds of death within 5 years, respectively.

Results

Overall, 133 patients were greater than or equal to 5-year survivors; 127 were less than 5-year survivors. Burden of pathogenic comutations including TP53 and PIK3CA was similar between greater than or equal to 5-year survivors and less than 5-year survivors. Receipt of first-line chemotherapy rather than EGFR tyrosine kinase inhibitor was similar between the groups (22% of <5-y versus 31% of ≥5-y). Baseline brain metastasis and history of smoking were associated with higher odds of death within 5 years (odds ratio = 2.16, p = 0.029 and odds ratio = 1.90, p = 0.046, respectively). Among patients without baseline brain metastases, cumulative incidence of brain metastases at 5 years was 42.3%. Both baseline and post-baseline brain metastasis were associated with worse overall survival compared with no brain metastasis (hazard ratio = 3.26, p < 0.001 and hazard ratio = 4.99, p < 0.001, respectively).

Conclusions

Within patients treated for EGFRm metastatic NSCLC before 2015, absence of brain metastasis and nonsmoking status were predictive of 5-year survival. Our findings help to define a subset of patients with EGFRm NSCLC with excellent survival outcomes who may not require intensification of initial therapy.

表皮生长因子受体突变(EGFRm)转移性非小细胞肺癌(mNSCLC)长期存活者的特征
导言表皮生长因子受体突变型(EGFRm)NSCLC长期存活者的特征尚未完全清楚。这项回顾性分析评估了在前奥希替尼时代接受治疗的EGFRm NSCLC患者的多机构队列,并试图描述长期存活者的特征。方法从2015年前开始一线治疗的EGFRm转移性NSCLC患者的电子病历中抽取临床特征和结果。对生存期大于或等于5年和小于5年的幸存者的人口统计学特征和合并症进行了比较。采用多变量考克斯比例危险模型和逻辑回归模型分别评估与存活率和5年内死亡几率相关的因素。结果总计有133名患者大于或等于5年存活;127名患者小于5年存活。包括TP53和PIK3CA在内的致病突变的负担在存活期大于或等于5年的患者和存活期小于5年的患者之间相似。两组间接受一线化疗而非表皮生长因子受体酪氨酸激酶抑制剂的比例相似(22%的5年存活者与31%的≥5年存活者)。基线脑转移和吸烟史与较高的5年内死亡几率相关(几率比分别为2.16,p=0.029和1.90,p=0.046)。在没有基线脑转移的患者中,5年后脑转移的累积发生率为42.3%。与无脑转移相比,基线脑转移和基线后脑转移都与总生存率降低有关(危险比=3.26,p <0.001和危险比=4.99,p <0.001)。结论在2015年前接受治疗的表皮生长因子受体m转移性NSCLC患者中,无脑转移和不吸烟状态可预测5年生存率。我们的研究结果有助于确定EGFRm NSCLC患者的一个亚群,该亚群具有良好的生存预后,可能不需要加强初始治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.20
自引率
0.00%
发文量
145
审稿时长
19 weeks
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