Nazha Bassel, Zhang Chao, Chen Zhengjia, Ragin Camille, Owonikoko Taofeek K
Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA.
Department of Biostatistics, Rollins School of Public Health, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA.
Cancers (Basel). 2022 Jun 30;14(13):3206. doi: 10.3390/cancers14133206.
Introduction: The crosstalk between receptor kinase signaling, such as EGFR and androgen receptor signaling, suggests a potential interaction between androgen deprivation therapy (ADT) and lung cancer outcome. Methods: We employed the SEER−Medicare data of lung cancer patients diagnosed between 1988 and 2005 to test for an association between ADT for prostate cancer and lung cancer outcome. We employed the Kaplan−Meier method and Cox proportional hazard with log-rank test model to assess any significant impact of ADT on survival. Results: We included data from 367,750 lung cancer patients; 17.4%, 2.9%, 33.6% and 46.1% with stages I, II, III and IV, respectively; 84.5% were >65 years; 57.2% males; 84.2% Caucasians and 9.3% Blacks. There were 11,061 patients (3%) with an initial prostate cancer diagnosis followed by lung cancer (P-L group); 3017 (0.8%) with an initial diagnosis of lung cancer and subsequent prostate cancer diagnosis (L-P group); the remainder had only lung cancer (L group). Stage I lung cancer was most common in the L-P group compared to the L and P-L groups—54% vs. 17.13% vs. 17.92%, p < 0.0001 for L-P, L and P-L, respectively. The median OS for lung cancer diagnosis was 93 months versus 10 and 9 months, respectively, for the L-P, L and P-L subgroups. ADT was associated with improved survival on multivariate analysis, especially in Caucasian patients (HR of death: 0.86; 95% CI: 0.76−0.97; p = 0.012). Conclusion: ADT was associated with improved outcome for NSCLC, in line with the hypothesis of a role for the androgen receptor in lung cancer. Our findings support a systematic evaluation of the potential benefit of ADT as a therapy for lung cancer.
受体激酶信号传导之间的相互作用，如表皮生长因子受体（EGFR）和雄激素受体信号传导，提示雄激素剥夺治疗（ADT）与肺癌预后之间可能存在相互作用。方法：我们利用1988年至2005年间诊断的肺癌患者的监测、流行病学和最终结果（SEER）-医疗保险数据，来检测前列腺癌的ADT与肺癌预后之间的关联。我们采用Kaplan-Meier方法和带有对数秩检验模型的Cox比例风险模型来评估ADT对生存的任何显著影响。结果：我们纳入了367,750例肺癌患者的数据；分别有17.4%、2.9%、33.6%和46.1%的患者处于I、II、III和IV期；84.5%的患者年龄>65岁；57.2%为男性；84.2%为白种人，9.3%为黑人。有11,061例患者（3%）最初诊断为前列腺癌，随后诊断为肺癌（P-L组）；3017例（0.8%）最初诊断为肺癌，随后诊断为前列腺癌（L-P组）；其余患者仅患有肺癌（L组）。与L组和P-L组相比，I期肺癌在L-P组中最为常见——分别为54%、17.13%和17.92%，L-P组、L组和P-L组之间的p值<0.0001。肺癌诊断后的中位总生存期分别为93个月、10个月和9个月，分别对应L-P组、L组和P-L亚组。多变量分析显示ADT与生存率提高相关，尤其是在白种人患者中（死亡风险比：0.86；95%置信区间：0.76−0.97；p = 0.012）。结论：ADT与非小细胞肺癌（NSCLC）预后改善相关，这与雄激素受体在肺癌中发挥作用的假设一致。我们的研究结果支持对ADT作为肺癌治疗方法的潜在益处进行系统评估。
