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H.J. Kim
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P2.03 - Chemotherapy/Targeted Therapy (ID 704)
- Event: WCLC 2017
- Type: Poster Session with Presenters Present
- Track: Chemotherapy/Targeted Therapy
- Presentations: 1
- Moderators:
- Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)
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P2.03-030 - Cumulative Smoking Dose Affects the Clinical Outcomes of EGFR-Mutated Lung Adenocarcinoma Patients Treated with EGFR-TKIs (ID 9159)
09:30 - 09:30 | Author(s): H.J. Kim
- Abstract
Background:
EGFR-mutated lung cancer patients are mostly found in never smoker but at least one third of the patients are ever smokers. Clinical outcomes are known to be variable according to the smoking history among EGFR-mutated lung adenocarcinoma patients when treated with EGFR-TKIs. The aim of this study is to investigate whether cumulative smoking dose affects the clinical outcomes such as progression-free survival (PFS) and overall survival (OS) in EGFR-mutated lung adenocarcinoma patients treated with EGFR-TKIs
Method:
We retrospectively analyzed 142 advanced or recurrent lung adenocarcinoma patients who harbored activating EGFR mutations (exon19 deletion or exon 21 L858R) and had received gefitinib, erlotinib or afatinib. Detailed smoking histories and smoking dose were obtained from all patients. The patients were classified into 4 groups by cumulative smoking dose (never smoker, ≤10 pack-years (PYs), 11-30 PYs and > 30 PYs). PFS and OS were analyzed according to smoking subgroups by Kaplan- Meier curves.
Result:
Among 142 EGFR-mutated patients, 91(64.1%) were never-smokers, 12(8.5%) were minimal smokers with ≤10 PYs, 22(15.5%) were moderate smokers with 11-30 PYs, and 17(12%) were heavy smokers with more than 30 PYs. Cumulative smoking dose was inversely associated with median PFS in dose-dependent manner with statistical significance. (11.8 months, 10.9months, 7.4 months, 3.9 months. p < 0.05). Kaplan-Meier curves of OS showed statistically significant negative association between cumulative smoking dose and median OS. (33.6months, 26.3months, 20 months, 8.9months: p<0.001) However, minimal smoker group less than 10 PYs showed very similar clinical outcomes of PFS and OS with never smoker group. In the multivariate analysis adjusted for age, sex, performance status, stage, and time point of EGFR-TKI treatment, cumulative smoking dose was an independent predictive factor for the disease progression (hazard ratio, 3.29; 95% confidence interval(CI), 1.68-6.45 p <0.001) and short OS(HR 4.3, 95% CI 2.1-8.7 p<0.001) to EGFR-TKIs.
Conclusion:
Cumulative smoking dose inversely affects the duration of response and survival to EGFR-TKIs in EGFR-mutated lung adenocarcinoma patients. Profiling of smoking-related gene signatures might be valuable for therapeutic decision besides EGFR mutation test in lung adenocarcinoma patients.
