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Characteristics of Long-Term Survivors With EGFR-Mutant Metastatic NSCLC.
Tompkins, William; Grady, Connor B; Hwang, Wei-Ting; Chandrasekhara, Krishna; McCoach, Caroline; Sun, Fangdi; Liu, Geoffrey; Patel, Devalben; Nieva, Jorge; Herrmann, Amanda; Marrone, Kristen; Lam, Vincent K; Velcheti, Vamsi; Liu, Stephen V; Montenegro, Gabriela Liliana Bravo; Patil, Tejas; Weiss, Jared; Miller, Kelsey Leigh; Schwartzman, William; Dowell, Jonathan E; Shaverdashvili, Khvaramze; Villaruz, Liza; Cass, Amanda; Iams, Wade; Aisner, Dara; Aggarwal, Charu; Camidge, D Ross; Marmarelis, Melina E; Sun, Lova.
Afiliación
  • Tompkins W; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Grady CB; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Hwang WT; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Chandrasekhara K; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • McCoach C; UCSF School of Medicine, University of California San Francisco, San Francisco, California.
  • Sun F; UCSF School of Medicine, University of California San Francisco, San Francisco, California.
  • Liu G; Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • Patel D; Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • Nieva J; University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California.
  • Herrmann A; University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, California.
  • Marrone K; Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Lam VK; Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Velcheti V; NYU Grossman School of Medicine, New York University, New York, New York.
  • Liu SV; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia.
  • Montenegro GLB; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia.
  • Patil T; University of Colorado Cancer Center, Aurora, Colorado.
  • Weiss J; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
  • Miller KL; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina.
  • Schwartzman W; Harold C Simmons Comprehensive Cancer Center, UT Southwestern, Dallas Texas.
  • Dowell JE; Harold C Simmons Comprehensive Cancer Center, UT Southwestern, Dallas Texas.
  • Shaverdashvili K; UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
  • Villaruz L; UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania.
  • Cass A; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Iams W; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Aisner D; University of Colorado Cancer Center, Aurora, Colorado.
  • Aggarwal C; Division of Hematology and Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Camidge DR; University of Colorado Cancer Center, Aurora, Colorado.
  • Marmarelis ME; Division of Hematology and Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • Sun L; Division of Hematology and Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
JTO Clin Res Rep ; 5(8): 100669, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39157674
ABSTRACT

Introduction:

Characteristics of long-term survivors in EGFR-mutant (EGFRm) NSCLC are not fully understood. This retrospective analysis evaluated a multi-institution cohort of patients with EGFRm NSCLC treated in the pre-osimertinib era and sought to describe characteristics of long-term survivors.

Methods:

Clinical characteristics and outcomes were abstracted from the electronic medical records of patients with EGFRm metastatic NSCLC who started first-line therapy before 2015. Demographics and comutations were compared between greater than or equal to 5-year survivors and less than 5-year survivors. Multivariable Cox proportional hazard and logistic regression models were used to evaluate factors associated with survival and the odds of death within 5 years, respectively.

Results:

Overall, 133 patients were greater than or equal to 5-year survivors; 127 were less than 5-year survivors. Burden of pathogenic comutations including TP53 and PIK3CA was similar between greater than or equal to 5-year survivors and less than 5-year survivors. Receipt of first-line chemotherapy rather than EGFR tyrosine kinase inhibitor was similar between the groups (22% of <5-y versus 31% of ≥5-y). Baseline brain metastasis and history of smoking were associated with higher odds of death within 5 years (odds ratio = 2.16, p = 0.029 and odds ratio = 1.90, p = 0.046, respectively). Among patients without baseline brain metastases, cumulative incidence of brain metastases at 5 years was 42.3%. Both baseline and post-baseline brain metastasis were associated with worse overall survival compared with no brain metastasis (hazard ratio = 3.26, p < 0.001 and hazard ratio = 4.99, p < 0.001, respectively).

Conclusions:

Within patients treated for EGFRm metastatic NSCLC before 2015, absence of brain metastasis and nonsmoking status were predictive of 5-year survival. Our findings help to define a subset of patients with EGFRm NSCLC with excellent survival outcomes who may not require intensification of initial therapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JTO Clin Res Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: JTO Clin Res Rep Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos