Syrigos Konstantinos N, Georgoulias Vasilis, Zarogoulidis Konstantinos, Makrantonakis Paris, Charpidou Andriani, Christodoulou Christos
Oncology Unit, 3rd Department of Medicine, Medical School, National & Kapodistrian University of Athens, Athens, Greece
Laboratory of Tumor Cell Biology, School of Medicine, University of Crete, Heraklion, Greece.
Anticancer Res. 2018 Jun;38(6):3735-3744. doi: 10.21873/anticanres.12654.
BACKGROUND/AIM: Real-world evidence regarding the prevalence of epidermal growth factor receptor (EGFR) mutation-positive status (M+) and the clinicopathological characteristics associated with the presence of EGFR mutations in advanced non-small cell lung cancer (NSCLC) is scarce, especially among Caucasian populations. The present study aimed to bridge this gap, as well as to record treatment patterns and outcomes in routine-care settings.
REASON (NCT01153399) was a prospective study of patients with stage IIIB/IV NSCLC and known EGFR mutation status. Clinicopathological, treatment characteristics and clinical outcomes were recorded and correlated with EGFR mutation testing results.
Of 575 enrolled patients, EGFR mutations were detected in 15.7% of them. Male gender (p=0.008) and smoking (p<0.001), but not adenocarcinoma, were associated with EGFR M+ status. In the EGFR M+ subpopulation (n=88), absence of bone and/or brain metastasis and presence of exon 19 EGFR M+ status at diagnosis were independently associated with longer progression-free survival (PFS) (p=0.011 and p=0.040, respectively).
In our population, males and smokers had decreased odds of harboring an EGFR mutation, while adenocarcinoma histology was not a significant predictor of EGFR M+ status. EGFR M+ patients with bone and/or brain metastases at diagnosis or mutations other than exon 19 deletions were at increased risk for earlier disease progression.
背景/目的:关于晚期非小细胞肺癌(NSCLC)中表皮生长因子受体(EGFR)突变阳性状态(M+)的患病率以及与EGFR突变存在相关的临床病理特征的真实世界证据稀缺,尤其是在白种人群体中。本研究旨在填补这一空白,并记录常规护理环境中的治疗模式和结果。
REASON(NCT01153399)是一项针对IIIB/IV期NSCLC且已知EGFR突变状态患者的前瞻性研究。记录临床病理、治疗特征和临床结果,并将其与EGFR突变检测结果相关联。
在575名入组患者中,15.7%检测到EGFR突变。男性(p = 0.008)和吸烟(p < 0.001)与EGFR M+状态相关,但腺癌与EGFR M+状态无关。在EGFR M+亚组(n = 88)中,诊断时无骨和/或脑转移以及存在外显子19 EGFR M+状态与更长的无进展生存期(PFS)独立相关(分别为p = 0.011和p = 0.040)。
在我们的研究人群中,男性和吸烟者携带EGFR突变的几率降低,而腺癌组织学不是EGFR M+状态的显著预测因素。诊断时伴有骨和/或脑转移或外显子19缺失以外突变的EGFR M+患者疾病进展较早的风险增加。