Author of

• 12824

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  P3.21 - Poster Session 3 - Diagnosis and Staging (ID 171)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Prevention & Epidemiology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12826

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    P3.21-002 - Lung-EPICLIN: analysis of <em>EGFR</em> mutations and associated clinico-pathological parameters in patients with NSCLC in Russian Federation (ID 1409)

    09:30 - 09:30  |  Author(s): I.V. Pimenov
    • Abstract

    Background
    Lung cancer is a major cause of mortality in Russia: 51,364 deaths in 2008, 18.0% of all cancer-related deaths (GLOBOCAN). Mutations in the EGFR gene are known to predict for sensitivity to EGFR tyrosine kinase inhibitors in patients with advanced non-small-cell lung cancer (NSCLC). Clinico-pathological characteristics associated with a higher prevalence of EGFR mutations are: adenocarcinoma histology, East Asian origin, non-smoking history, and female gender. This study aimed to document the characteristics, clinical management and outcomes of Russian patients with NSCLC, and to investigate associations between EGFR mutations and clinico-pathological parameters.

    Methods
    A non-interventional, prospective cohort study (ClinTrials ID: NCT01069835) carried out in a representative selection of hospitals in order to assess lung cancer management in countries throughout European and Asian parts of Russia. Patients with confirmed NSCLC attending participating centres for the first time between 1 February 2010 and 31 March 2011 were enrolled and followed-up according to routine practice for a minimum of 12 months or until death.

    Results
    A total of 838 patients were enrolled at 33 sites across the Russian Federation. Baseline characteristics were: mean age, 58.7 (SD ±8.5) years; male, 78.4%; European, 98.0%; Russian, 79.6%; Tatar, 3.8%; Ukrainian, 3.1%; Byelorussian, 1.3%; current smokers, 49.4%; never-smokers, 26.5%; ECOG performance status (PS) 1, 65.6%; disease stage IV, 25.4%; stage III, 37.8%; stage I/II, 36.7%. Metastases were found in 38.1% of patients; the most common metastatic sites included: respiratory system, 70.2%; pleura, 17.2%; bone, 11.9%; liver, 10.3%. EGFR mutations were detected in 85/838 (10.1%) patients (84/821 [10.2%] European patients and 1/15 [6.7%] Asian patients), who were mostly women, 69.4%; <70 years old, 85.9%; never smokers, 71.8%; PS 1, 59.3%; adenocarcinoma, 58.8%. EGFR mutation rates by histological type were: squamous-cell carcinoma (SCC), 18/455 (4.0%); adenocarcinoma, 50/260 (19.2%); adenocarcinoma bronchioloalveolar, 11/54 (20.4%); large-cell carcinoma, 2/24 (8.3%); adenosquamous carcinoma, 2/19 (10.5%); other histology, 2/26 (7.7%). Logistic regression analysis of EGFR mutations; statistically significant odds ratios: male vs female, 0.086 (p<0.0001); any smoking history vs no smoking history, 0.110 (p<0.0001); non-SCC vs SCC, 5.365 (p<0.0001); increase in age (10 years), 1.391 (p=0.0227). Platinum-containing doublets were the most commonly used chemotherapy at first (83.5%) and second line (51.0%). In patients who received first- and second-line chemotherapy, objective response rate, disease progression rate and median progression-free survival (PFS) were, respectively, 16.1% and 3.6%, 63.8% and 76.8%, 35.0 weeks and 19.4 weeks. Median PFS (weeks) after first-line chemotherapy by histology and EGFR mutation status was: SCC, 36.3; non-SCC, 34.0; EGFR mutation positive, 36.9; EGFR mutation negative, 34.3.

    Conclusion
    In this cohort, the proportion of patients with EGFR mutation-positive NSCLC was similar to other studies of NSCLC in Caucasian populations. EGFR mutation status was significantly associated with female gender and non-smoking history, in-line with previous studies of Asian and Caucasian patients with advanced NSCLC. This study contributes to a better understanding of prognostic and predictive factors of NSCLC, which will enable optimal treatment selection in future clinical practice.