Lung Cancer: Lung Cancer: Genetics |

Impact of Ethnicity on the Initial Incidence of Brain Metastasis in Patients With EGFR-Mutant Lung Cancer FREE TO VIEW

Jiexia Zhang, MD; Jianxing He, MD
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Guangzhou Respiratory Institute, Guangzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A276. doi:10.1016/j.chest.2016.02.288
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SESSION TITLE: Lung Cancer: Genetics

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: The objective of this study was to determine the incidence of brain metastasis at initial diagnosis in East Asian and Caucasian patients with EGFR-mutant lung cancer.

METHODS: Descriptive statistics were generated for demographics, smoking habits, histology, and EGFR mutation subtypes, stratified by status of brain metastasis at diagnosis. Chi-squared tests and t-tests were used for testing associations of categorical variables and continuous variables with brain metastasis at diagnosis, respectively. Logistic regression models were used to study the association between race and brain metastasis at diagnosis, with and without adjusting for age at initial diagnosis, gender, EGFR mutation type, smoking status, and histology. Odds ratio (OR) and corresponding 95% confidence intervals (CI) were obtained. All analyses were two sided and a p value <0.05 were considered significant.

RESULTS: N=160, 44.2% were Caucasians and 55.8% East Asians. Higher incidence of brain metastasis at diagnosis was detected in East Asian patients than Caucasian patients (42.1% vs 13.8%, p= 0.0001). There is no significant difference in the mean age (62 and 59 years old), smoking history (34.2% vs 26.5%), histology (93.8% adenocarcinoma in both groups), type of EGFR mutation (Exon 19 Deletion: 47.8% vs 48.0%; L858R: 35.4% vs 38.0%) between patients without brain metastasis and with brain metastasis at diagnosis. Comparing to Caucasians, East Asians had significantly higher incidence of brain metastasis at diagnosis (OR = 4.53, 95% CI: 2.01-10.20, p= 0.0003). The result remained significant after adjusting for other factors (aOR = 4.24, 95% CI: 1.76-10.18, p= 0.001).

CONCLUSIONS: Regardless of place of residence (Northern California or China), East Asians had significantly higher incidence of brain metastasis at diagnosis (OR = 4.53, 95% CI: 2.01-10.20, p= 0.0003). This result remained significant after adjusting for other factors (aOR = 4.24, 95% CI: 1.76-10.18, p= 0.001), which suggests that ethnicity-related genomic and pharmacogenomic differences and less impact of environmental factors on tumorigenesis and clinical course of EGFR-mutant lung cancer.

CLINICAL IMPLICATIONS: Further study is warranted to understand the impact of ethnicity and population-related genomics and pharmacogenomics on tumor biology of EGFR-mutant lung cancer.

DISCLOSURE: The following authors have nothing to disclose: Jiexia Zhang, Jianxing He

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