Abstract
Non-small-cell lung cancer (NSCLC) with uncommon metastasis has a poor prognosis. NSCLC patients with epidermal growth factor receptor (EGFR) mutations have more lung, brain, and bone metastases than those with wild-type EGFR. We aimed to clarify differences in prognosis in advanced EGFR mutation-positive NSCLC patients with common and uncommon metastasis.
Chemotherapy-naive advanced NSCLC patients with mutated EGFR diagnosed from January 2010 to March 2016 were divided into two groups (those with lung, brain, and bone metastases [common metastasis group], and those with distant metastases in other sites [uncommon metastasis group]), and their clinical characteristics and outcomes were compared.
We identified 45 patients with common metastasis and 18 with uncommon metastasis. Median progression-free survival (PFS) and overall survival (OS) were significantly longer in the common metastasis group than in the uncommon metastasis group (PFS: 13.0 months [95% confidence interval (CI) 9.1-20.8] vs 5.5 months [4.1-10.2], hazard ratio (HR) 0.26 [95% CI 0.13-0.53], p < 0.001; OS: 39.0 months [95% CI 23.7-77.8] vs 14.8 months [5.7-18.6], HR 0.28 [95% CI 0.14-0.56], p < 0.001). Uncommon metastasis was an independent prognostic factor for PFS (HR 0.25 [95% CI 0.12-0.53], p < 0.001) and OS (HR 0.33 [95% CI 0.16-0.69], p = 0.0029). Seventeen patients in both groups underwent re-biopsy after recurrence; no patients in the uncommon metastasis group acquired the EGFR T790M mutation.
Distant metastases in sites other than the lung, brain, and bone in advanced NSCLC patients with mutated EGFR indicate a poor prognosis. The site of distant metastasis may suggest the resistance to EGFR tyrosine kinase inhibitors.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, PA2801.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018