切除的 - 突变非小细胞肺癌：欧洲人群中的发病率和结局（GFPC Exerpos研究）
Resected -mutated non-small-cell lung cancers: incidence and outcomes in a European population (GFPC Exerpos Study).
作者信息
Auliac Jean-Bernard, Thomas Pascal-Alexandre, Bylicki Olivier, Guisier Florian, Curcio Hubert, Swalduz Aurelie, Wislez Marie, Le Treut Jacques, Decroisette Chantal, Basse Victor, Falchero Lionel, De Chabot Gonzague, Moreau Diane, Huchot Eric, Lupo Mansuet Audrey, Blons Helene, Chouaïd Christos, Greillier Laurent
机构信息
Service de Pneumologie, Pneumology Department, CHI Créteil, 40 Avenue de Verdun, Creteil 94010, France.
Thoracic Surgery Department, Assistance Publique Hopitaux de Marseille, Marseille, France.
出版信息
Ther Adv Med Oncol. 2024 Mar 6;16:17588359241236451. doi: 10.1177/17588359241236451. eCollection 2024.
BACKGROUND
Few epidemiological data are available on surgically treated Caucasian patients with non-small-cell lung cancers (NSCLCs) harboring epidermal growth factor receptor () mutations. The main objective of this study was to describe, in the real-world setting, these patients' incidence, clinical, and tumoral characteristics.
METHODS
The participating centers included all consecutive localized non-squamous NSCLC patients undergoing surgery between January 2018 and December 2019 in France. status was determined retrospectively when not available before surgery.
RESULTS
The study includes 1391 no squamous NSCLC patients from 16 centers; status was determined before surgery in 692 (49.7%) of the cases and conducted as part of the study for 699 (50.3%); 171 (12.3%) were mutated; median age: 70 (range: 36-88) years; female: 59.6%; never smokers: 75.7%; non-squamous histology 97.7%, programmed death ligand-1 expression 0%/1-49%/⩾50 in 60.5%/25.7%/13.8%, respectively. Surgery was predominantly lobectomy (81%) or segmentectomy (14.9%), with systematic lymph node dissection in 95.9%. Resection completeness was R0 for 97%. Post-surgery staging was as follows: IA: 52%, IB: 16%, IIA: 4%, IIB: 10%, IIIA: 16%, and IIIB: 0.05%; mutation exon was Del19/exon 21 ()/20/18 in 37.4%/36.8%/14%, and 6.4% of cases, respectively; 31 (18%) patients received adjuvant treatment (chemotherapy: 93%, EGFR tyrosine kinase inhibitor: 0%, radiotherapy: 20%). After a median follow-up of 31 (95% confidence interval: 29.6-33.1) months, 45 (26%) patients relapsed: 11/45 (24%) locally and 34 (76%) with metastatic progression. Median disease-free survival (DFS) and overall survival were not reached and 3-year DFS was 60%.
CONCLUSION
This real-world analysis provides the incidence and outcomes of resected -mutated NSCLCs in a European patient cohort.
背景
关于接受手术治疗的携带表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）白种患者的流行病学数据较少。本研究的主要目的是在真实世界环境中描述这些患者的发病率、临床和肿瘤特征。
方法
参与研究的中心包括2018年1月至2019年12月期间在法国接受手术的所有连续局部非鳞状NSCLC患者。若术前未检测EGFR状态，则进行回顾性确定。
结果
该研究纳入了来自16个中心的1391例非鳞状NSCLC患者；692例（49.7%）患者在术前确定了EGFR状态，699例（50.3%）患者在研究过程中进行了检测；171例（12.3%）患者发生EGFR突变；中位年龄：70岁（范围：36 - 88岁）；女性：59.6%；从不吸烟者：75.7%；非鳞状组织学类型占97.7%，程序性死亡配体-1表达分别为0%/1 - 49%/≥50%的患者占60.5%/25.7%/13.8%。手术主要为肺叶切除术（81%）或肺段切除术（14.9%），95.9%的患者进行了系统性淋巴结清扫。97%的患者切除完整度为R0。术后分期如下：IA期：52%，IB期：16%，IIA期：4%，IIB期：10%，IIIA期：16%，IIIB期：0.05%；EGFR突变外显子为Del19/外显子21（L858R）/外显子20/外显子18的患者分别占37.4%/36.8%/14%和6.4%；31例（18%）患者接受了辅助治疗（化疗：93%，EGFR酪氨酸激酶抑制剂：0%，放疗：20%）。中位随访31（95%置信区间：29.6 - 33.1）个月后，45例（26%）患者复发：11/45例（24%）为局部复发，34例（76%）为远处转移进展。无病生存期（DFS）和总生存期未达到，3年DFS率为60%。
结论
这项真实世界分析提供了欧洲患者队列中切除的EGFR突变NSCLC的发病率和预后情况。
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