sábado, 9 de enero de 2016

Five-year survival in EGFR-mutant metastatic lung adenocarcinoma treated with EGFR-TKIs.

2015 Dec 24. pii: S1556-0864(15)00265-8. doi: 10.1016/j.jtho.2015.12.103. [Epub ahead of print]

Five-year survival in EGFR-mutant metastatic lung adenocarcinoma treated with EGFR-TKIs.
Lin Jessica J, et al. Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer 2015 12 (From HuGE Literature Finder)

Five-year survival in EGFR-mutant metastatic lung adenocarcinoma treated with EGFR-TKIs.

Lin JJ1, Cardarella S2, Lydon CA2, Dahlberg SE3, Jackman DM4, Jänne PA4, Johnson BE5.

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Abstract

INTRODUCTION:

Activating mutations in the epidermal growth factor receptor (EGFR) predict for prolonged progression-free survival (PFS) in patients with advanced non-small cell lung cancer (NSCLC) treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) versus chemotherapy. Long-term survival outcomes, however, remain undefined. The objective of this study was to determine the 5-year survival in these patients, and identify clinical factors associated with overall survival (OS).

METHODS:

Patients with EGFR-mutant metastatic lung adenocarcinoma treated with erlotinib or gefitinib at Dana-Farber Cancer Institute between 2002 and 2009 were included. OS was analyzed.

RESULTS:

Among 137 patients, median PFS and OS were 12.1 months (95% CI, 10.2-13.5 months) and 30.9 months (95% CI, 28.2-35.7 months), respectively. Twenty patients (14.6%) were 5-year survivors. In multivariate analysis, exon 19 deletions (hazard ratio [HR], 0.63; 95% CI, 0.44-0.91; P = 0.01), absence of extrathoracic (HR 0.62; 95% CI, 0.41-0.93; P = 0.02) or brain metastasis (HR 0.48; 95% CI, 0.30-0.77, P = 0.002), and non-current smoking status (HR 0.23; 95% CI, 0.09-0.59; P = 0.002) were associated with prolonged OS. Age, gender, stage at diagnosis, liver or bone or adrenal metastasis, specific TKI, and line of TKI therapy were not associated with OS.

CONCLUSIONS:

Our data suggest that the prevalence of 5-year survival among EGFR-mutant metastatic lung adenocarcinoma patients treated with erlotinib or gefitinib is 14.6%. Exon 19 deletions and absence of extrathoracic or brain metastasis are associated with prolonged survival. Based on our findings, clinicians can gain an enhanced estimation of long-term outcomes in this population.