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P. Maceachern
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P3.02b - Poster Session with Presenters Present (ID 494)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)
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P3.02b-020 - Gender and Ethnicity Influence on Outcome in EGFRmut+ NSCLC Patients Treated at a Single Canadian Institution (ID 5096)
14:30 - 14:30 | Author(s): P. Maceachern
- Abstract
Background:
EGFR-mutations are associated with adenocarcinoma, female, never/light smoking and East-Asian ethnicity. Several clinical studies have shown that EGFR-TKIs are superior to platin-based chemotherapy in EGFRmut[+] NSCLC patients; however there is insufficient literature that examines differences in survival based on East-Asian ethnicity, independent of the EGFR mutation type, gender, smoking history and disease recurrence in an all EGFRmut[+ ]NSCLC cohort.
Methods:
A retrospective study of EGFRmut[+] NSCLC patients treated with EGFR-TKIs was conducted at the Tom Baker Cancer Centre in Calgary, Canada between March 2010 and December 2014. Ethnicity was defined by place of birth. Comparison of smoking history was made using Pearson χ[2] statistic. Survival analyses according to gender, smoking history and EGFR mutation type were estimated using the Kaplan-Meier method, with comparisons made between groups by the log-rank test. All statistical analyses were conducted using STATA. Statistical significance was assumed for a two-tailed p value < 0.05.
Results:
A total of 138 patients were identified (61 [44.2%] Asians; 77 [55.8%] non-Asians). Of these, 92 died, eight were lost to follow up and 38 were alive as of June 1, 2016. In the Asian subgroup, the median age was 64.4 years, 67% were female, and 71% were never/non-smokers. Meanwhile, in the non-Asian subgroup, the median age was 66.5 years, 61% were female and only 39% were never/non-smokers. The median PFS for Asians vs non-Asians was 8.7m and 8.2m, while the median OS was 25.6m and 16.1m, respectively. The log rank test demonstrated a statistically significant difference in survival between Asians vs non-Asians (p= 0.026). KM curves showed that: (i) smoking was an important demographic feature as non-Asians with a smoking history had the worst median survival (17.5m); Pearson χ[2] showed that the overall relationship between ethnicity and smoking history was significant, p < 0.001; (ii) Asian-females/males had longer survival (23.4m; 21.5m, respectively) than non-Asian females/males (19.7m; 14.5m, respectively) and (iii) regardless of EGFR-mutation type, Asians (exon 19 deletions: 25.9m, exon 21 (L858R): 20.4m) outlived non-Asians (exon 19 deletions: 19.6m and exon 21: 14.9m).
Conclusion:
The demographics from our study are consistent with findings from IPASS and EURTAC. Our current survival estimates suggest that even in a cohort of EGFRmut[+]NSCLC treated with an EGFR-TKI, there seems to be a survival benefit for Asian-ethnicity, even after stratifying by gender, smoking history and EGFR-mutation type. *This study was supported by AstraZeneca.
