Author of

• 15209

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  P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)

  • Event: WCLC 2015
  • Type: Poster
  • Track: Treatment of Advanced Diseases - NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)

  • 15218

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    P3.01-009 - Impact of EGRR Mutation on Brain Metastasis and Disease-Free Survival in Patients with Surgically Resected Lung Adenocarcinoma (ID 1180)

    09:30 - 09:30  |  Author(s): T. Akamatsu
    • Abstract

    Background:
    Central nervous system (CNS) invasion is a common occurrence in patients with non-small-cell lung cancer (NSCLC) and is associated with poor outcome. For patients who develop CNS invasion, epidermal growth factor receptor (EGFR) mutation derives clinical benefits from EGFR tyrosine kinase inhibitors (TKIs). The clinical manifestation of CNS invasion, EGFR mutation, and prognosis are unclear in patients with resected stage I to III lung adenocarcinoma.
    
    Methods:
    The records of 261 patients with completely resected stage I to III lung adenocarcinoma who were hospitalized between March 2002 and January 2013 were reviewed retrospectively. Their pathological records indicated that EGFR mutation testing had been performed. Data on basic patient demographics, EGFR mutation, disease-free survival (DFS), and postoperative recurrence were collected. Kaplan Meier curves were used for survival analysis.
    
    Results:
    Of the 261 patients (median age: 68, range: 31-90) identified, 49% were male and 53% were EGFR mutant. Tumor stages were I, II, and III in 153, 47, and 61 patients, respectively.DFS after surgery for stage I, II, and III EGFR-mutant patients were 62 mo, 40 mo, and 29 mo, respectively, and 71 mo, 30 mo, and 74 mo, respectively, for patients with wild-type EGFR, showing no significant difference (p=0.19). Recurrence after surgery occurred in 124 patients (36 with CNS, 23 with bone metastasis, and 87 with other organ metastasis).In patients with CNS relapse, the incidence of CNS relapse as first metastasis was significantly high at 13.3% for EGFR-mutant patients, compared with 4.3% for wild-type EGFR patients (HR 2.5, p=0.046). As for second CNS metastasis, there was no significant difference between EGFR-mutant patients (8.1%) and wild-type EGFR patients (4.2%) (p=0.44).In patients whose first relapse was CNS metastasis, DFS after surgery was significantly longer at 22 months for EGFR-mutant patients, compared with 8 months for wild-type EGFR patients (p=0.012). Patients with recurrence in other organs showed no significant differences in terms of DFS regardless of being EGFR mutant or not.
    
    Conclusion:
    The EGFR-mutant patients showed a higher incidence of brain metastasis as the first relapse, and significantly longer DFS than the wild-type EGFR patients. In the present study, the brain metastasis of postoperative lung adenocarcinoma as the first relapse was limited to early in the wild-type EGFR patients, but occurred in later in the EGFR-mutant patients.