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L. Glassman
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-036 - Long Term Survival of Patients with Metastatic Adenocarcinoma of the Lung in the Era of Targeted Agents (ID 1307)
09:30 - 09:30 | Author(s): L. Glassman
- Abstract
Background:
Several studies have shown that tyrosine kinase inhibitors and chemotherapy improve the short term and median survival of patients with metastatic adenocarcinoma of the lung (MAL), but the long term survival (LTS) of these patients has not been thoroughly investigated.
Methods:
We performed a univariate retrospective analysis on 174 patients with MAL diagnosed at our institution between 2009 and 2011, and with up to a 5-year follow-up. Most patients received multiple treatment modalities. Overall survival was estimated using the product-limit method and compared using the log-rank test (significant results listed in Table 1); patients alive at last follow-up were censored.
Results:
In our series, 19% (33) of all patients (174) received erlotinib as part of their treatment, and 39%(13) of those receiving erlotinib had epidermal growth factor receptor (EGFR) mutations. Although the 2-year and median survival were superior in patients receiving erlotinib and chemotherapy, neither improved the 5-year survival rate (LTS). Surprinsingly, the 60-months survival rate was higher in the no erlotinib arm (Figure 1). The only treatment modality that significantly improved LTS was surgery. For the patients treated with erlotinib and chemotherapy, regardless of EGFR mutations, all observed deaths occurred within 4 years. Factors associated with LTS were: sex, surgery, and presence of metastatic disease confined to the the lungs.
Conclusion:
In our univariate retrospective analysis, MAL patients who were treated with erlotinib and chemotherapy had improved 2-year and median survival rates compared to patients treated with chemotherapy alone, but had no improvement in LTS. Factors such as: surgery, metastases limited to the lungs only, female sex were associated with LTS in MAL patients, but larger prospective studies are needed to confirm our findings. Our study puts into question the long term survival benefit of tyrosine kinase inhibitors in MAL and suggests a prominent role of surgery in this clinical context. Figure 1 Figure 2
