{"title":"股骨骨转移是egfr - tkis治疗的egfr突变非小细胞肺癌患者预后不良的因素：一项回顾性、多中心队列研究。","authors":"Ichidai Tanaka, Kazumi Hori, Junji Koyama, Soei Gen, Masahiro Morise, Yuta Kodama, Akira Matsui, Ayako Miyazawa, Tetsunari Hase, Yoshitaka Hibino, Toshihiko Yokoyama, Tomoki Kimura, Norio Yoshida, Mitsuo Sato, Makoto Ishii","doi":"10.1177/17588359241303090","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong><i>Epidermal growth factor receptor</i> (<i>EGFR</i>)-mutant non-small-cell lung cancers (NSCLCs) have higher frequencies of bone metastases than those of wild type; however, the metastatic pattern and influence on clinical outcome remain unclear.</p><p><strong>Objectives: </strong>To analyze the association between bone metastatic sites and the clinical efficacy of the first-, second-, and third-generation EGFR-tyrosine kinase inhibitors (TKI), in these patients.</p><p><strong>Design: </strong>Retrospective multicenter cohort study.</p><p><strong>Methods: </strong>The clinical data of patients with advanced-NSCLC harboring <i>EGFR</i> mutation, who were treated by EGFR-TKIs as first-line treatment at five medical institutions (<i>N</i> = 411), were retrospectively assessed for bone metastatic sites, overall survival (OS), and progression-free survival (PFS).</p><p><strong>Results: </strong>Bone metastases were found in 41.1% of the patients at diagnosis, including 13.1%, 8.0%, and 20.0 for single, double, and multiple lesions (⩾3), respectively. The vertebra (76.3%) and pelvis (60.9%) were the most frequent metastatic sites. Femoral-, sternum-, and scapula-metastases were remarkably increased in the patients with multiple-bone metastases. In the <i>EGFR</i>-mutant NSCLC patient treated with osimertinib, both the OS and the PFS of the patients with femoral bone metastasis were significantly shorter than those of the patients without femoral bone metastasis (OS: not reached vs 12.1 months, <i>p</i> < 0.0001; and PFS: 17.2 vs 9.3 months, <i>p</i> < 0.0018). Furthermore, a multivariable Cox regression analysis, including several poor prognostic factors, such as <i>L858R</i> mutation and liver metastasis, demonstrated that femoral bone metastasis was a statistically independent predictor of OS.</p><p><strong>Conclusion: </strong>Femoral bone metastasis is associated with poor survival of <i>EGFR</i>-mutant NSCLC patients who were treated with EGFR-TKIs, including osimertinib, and is an independent prognostic factor of OS.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"16 ","pages":"17588359241303090"},"PeriodicalIF":4.3000,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662391/pdf/","citationCount":"0","resultStr":"{\"title\":\"Femoral bone metastasis is a poor prognostic factor in EGFR-TKIs-treated patients with <i>EGFR</i>-mutated non-small-cell lung cancer: a retrospective, multicenter cohort study.\",\"authors\":\"Ichidai Tanaka, Kazumi Hori, Junji Koyama, Soei Gen, Masahiro Morise, Yuta Kodama, Akira Matsui, Ayako Miyazawa, Tetsunari Hase, Yoshitaka Hibino, Toshihiko Yokoyama, Tomoki Kimura, Norio Yoshida, Mitsuo Sato, Makoto Ishii\",\"doi\":\"10.1177/17588359241303090\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong><i>Epidermal growth factor receptor</i> (<i>EGFR</i>)-mutant non-small-cell lung cancers (NSCLCs) have higher frequencies of bone metastases than those of wild type; however, the metastatic pattern and influence on clinical outcome remain unclear.</p><p><strong>Objectives: </strong>To analyze the association between bone metastatic sites and the clinical efficacy of the first-, second-, and third-generation EGFR-tyrosine kinase inhibitors (TKI), in these patients.</p><p><strong>Design: </strong>Retrospective multicenter cohort study.</p><p><strong>Methods: </strong>The clinical data of patients with advanced-NSCLC harboring <i>EGFR</i> mutation, who were treated by EGFR-TKIs as first-line treatment at five medical institutions (<i>N</i> = 411), were retrospectively assessed for bone metastatic sites, overall survival (OS), and progression-free survival (PFS).</p><p><strong>Results: </strong>Bone metastases were found in 41.1% of the patients at diagnosis, including 13.1%, 8.0%, and 20.0 for single, double, and multiple lesions (⩾3), respectively. The vertebra (76.3%) and pelvis (60.9%) were the most frequent metastatic sites. Femoral-, sternum-, and scapula-metastases were remarkably increased in the patients with multiple-bone metastases. In the <i>EGFR</i>-mutant NSCLC patient treated with osimertinib, both the OS and the PFS of the patients with femoral bone metastasis were significantly shorter than those of the patients without femoral bone metastasis (OS: not reached vs 12.1 months, <i>p</i> < 0.0001; and PFS: 17.2 vs 9.3 months, <i>p</i> < 0.0018). Furthermore, a multivariable Cox regression analysis, including several poor prognostic factors, such as <i>L858R</i> mutation and liver metastasis, demonstrated that femoral bone metastasis was a statistically independent predictor of OS.</p><p><strong>Conclusion: </strong>Femoral bone metastasis is associated with poor survival of <i>EGFR</i>-mutant NSCLC patients who were treated with EGFR-TKIs, including osimertinib, and is an independent prognostic factor of OS.</p>\",\"PeriodicalId\":23053,\"journal\":{\"name\":\"Therapeutic Advances in Medical Oncology\",\"volume\":\"16 \",\"pages\":\"17588359241303090\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-12-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662391/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Therapeutic Advances in Medical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/17588359241303090\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Medical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/17588359241303090","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：表皮生长因子受体（EGFR）突变型非小细胞肺癌（nsclc）骨转移的发生率高于野生型；然而，转移模式和对临床结果的影响尚不清楚。目的：分析骨转移部位与第一代、第二代和第三代egfr -酪氨酸激酶抑制剂（TKI）在这些患者中的临床疗效之间的关系。设计：回顾性多中心队列研究。方法：回顾性分析在5家医疗机构接受EGFR- tkis作为一线治疗的EGFR突变晚期nsclc患者（N = 411）的临床资料，评估骨转移部位、总生存期（OS）和无进展生存期（PFS）。结果:骨转移中发现41.1%的病人在诊断,包括13.1%、8.0%,20.0,单,双,分别和多个病变(⩾3)。椎骨（76.3%）和骨盆（60.9%）是最常见的转移部位。多发骨转移患者的股骨、胸骨和肩胛骨转移明显增加。在egfr突变的NSCLC患者中，有股骨骨转移的患者的OS和PFS均明显短于无股骨骨转移的患者（OS：未达到vs 12.1个月，p p L858R突变和肝转移），表明股骨骨转移是OS的统计学独立预测因子。结论：EGFR-TKIs（包括奥西替尼）治疗的egfr -突变NSCLC患者股骨骨转移与生存率差相关，是OS的独立预后因素。
Femoral bone metastasis is a poor prognostic factor in EGFR-TKIs-treated patients with EGFR-mutated non-small-cell lung cancer: a retrospective, multicenter cohort study.
Background: Epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers (NSCLCs) have higher frequencies of bone metastases than those of wild type; however, the metastatic pattern and influence on clinical outcome remain unclear.
Objectives: To analyze the association between bone metastatic sites and the clinical efficacy of the first-, second-, and third-generation EGFR-tyrosine kinase inhibitors (TKI), in these patients.
Design: Retrospective multicenter cohort study.
Methods: The clinical data of patients with advanced-NSCLC harboring EGFR mutation, who were treated by EGFR-TKIs as first-line treatment at five medical institutions (N = 411), were retrospectively assessed for bone metastatic sites, overall survival (OS), and progression-free survival (PFS).
Results: Bone metastases were found in 41.1% of the patients at diagnosis, including 13.1%, 8.0%, and 20.0 for single, double, and multiple lesions (⩾3), respectively. The vertebra (76.3%) and pelvis (60.9%) were the most frequent metastatic sites. Femoral-, sternum-, and scapula-metastases were remarkably increased in the patients with multiple-bone metastases. In the EGFR-mutant NSCLC patient treated with osimertinib, both the OS and the PFS of the patients with femoral bone metastasis were significantly shorter than those of the patients without femoral bone metastasis (OS: not reached vs 12.1 months, p < 0.0001; and PFS: 17.2 vs 9.3 months, p < 0.0018). Furthermore, a multivariable Cox regression analysis, including several poor prognostic factors, such as L858R mutation and liver metastasis, demonstrated that femoral bone metastasis was a statistically independent predictor of OS.
Conclusion: Femoral bone metastasis is associated with poor survival of EGFR-mutant NSCLC patients who were treated with EGFR-TKIs, including osimertinib, and is an independent prognostic factor of OS.
期刊介绍：
Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).
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