Lung Cancer: Mechanisms of Lung Cancer |

The Impact of Precision EGFR Mutation Detection on the Treatment Patterns and Outcomes of Patients With Non-small Cell Lung Cancer (NSCLC): A Real-World Study in China FREE TO VIEW

Baohui Han; Jianlin Xu; Bo Jin; Tianqing Chu; Yuqing Lou; Xue Dong; Xueyan Zhang; Huiming Wang; Hua Zhong; Chunlei Shi; Aiqing Gu; Liwen Xiong; Yizhuo Zhao; Liyan Jiang; Jie Zhang
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Shanghai Jiaotong University Affiliated Shanghai Chest Hospital, Shanghai, China

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

Chest. 2016;149(4_S):A331. doi:10.1016/j.chest.2016.02.344
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SESSION TITLE: Mechanisms of Lung Cancer

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Saturday, April 16, 2016 at 02:15 PM - 03:45 PM

PURPOSE: To describe the importance of using EGFR mutation detection to guide the treatment of patients with NSCLC.

METHODS: 3132 (1301 patients had EGFR mutation detections; 1831 patients did not) stage IV NSCLC patients identified through the Shanghai Chest Hospital databases from January 2000 to December 2013. were studied in this retrospective analysis.

RESULTS: EGFR tyrosine kinase inhibitor (TKI) therapy was associated with improved OS in common EGFR mutant patients (adjusted HR, 0.25, 95% CI, 0.18-0.35; P < 0.001), uncommon EGFR mutant patients (aHR, 0.44, 95% CI, 0.20-0.99; P = 0.048) and patients of unknown EGFR mutation status (aHR, 0.73, 95% CI, 0.61-0.88; P = 0.001). For EGFR wild-type patients, TKIs failed to improved OS (aHR, 0.97, 95% CI, 0.75-1.26; P = 0.837). For 575 common EGFR mutant patients, TKIs plus 2+ line chemotherapy was associated with improved OS, compared with TKIs alone (aHR, 0.50, 95% CI, 0.37-0.69; P < 0.001) or TKIs plus 1 line chemotherapy (aHR, 0.73, 95% CI, 0.54-0.98; P = 0.037). Among 200 EGFR mutant patients receiving TKIs plus 2+ line chemotherapy, first line TKIs provided improved OS, compared with third+ line TKI therapy (aHR, 0.59, 95% CI, 0.35-0.98; P = 0.043). Compared with second line TKI therapy, first line did not show a significantly improved OS (aHR, 0.98, 95% CI, 0.61-1.58; P = 0.93).

CONCLUSIONS: EGFR mutation detection helped to select a subgroup of patients with common EGFR mutations who exhibited the best response to TKIs. First line TKIs treatment provided the best survival for common EGFR mutant patients. Chemotherapy was also a non-negligible aspect of NSCLC treatment.

CLINICAL IMPLICATIONS: EGFR gene detection helped to subclassify patients with NSCLC and to select EGFR TKI therapy for patients with common EGFR mutations to achieve the greatest likelihood of long-term survival. Patients who are positive for common EGFR mutations should be treated with EGFR TKIs as first line therapy. Chemotherapy still plays an important role in the treatment of patients harboring EGFR mutations.

DISCLOSURE: The following authors have nothing to disclose: Baohui Han, Jianlin Xu, Bo Jin, Tianqing Chu, Yuqing Lou, Xue Dong, Xueyan Zhang, Huiming Wang, Hua Zhong, Chunlei Shi, Aiqing Gu, Liwen Xiong, Yizhuo Zhao, Liyan Jiang, Jie Zhang

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