1256P - Long-term survivors in non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations: data from a randomized ph...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Biomarkers
Non-Small-Cell Lung Cancer, Metastatic
Presenter Yuji Minegishi
Authors Y. Minegishi1, K. Kobayashi2, M. Maemondo3, A. Inoue4, S. Sugawara5, S. Oizumi6, K. Hagiwara7, S. Morita8, T. Nukiwa9, A. Gemma10
  • 1Internal Medicine, Division Of Pulmonary Medicine, Infectious Diseases, And Oncology, Nippon Medical School, 113-8603 - Tokyo/JP
  • 2Respiratory Medicine, Saitama International Medical Center, 350-1298 - Saitama/JP
  • 3Department Of Respiratory Medicine, Miyagi Cancer Center, 981-1293 - Natori/JP
  • 4Department Of Respiratory Medicine, Tohoku University, JP-980-8575 - Sendai/JP
  • 5Department Of Respiratory Medicine, Sendai Kousei Hospital, Sendai/JP
  • 6First Department Of Medicine, Hokkaido University School of Medicine, 060-8638 - Sapporo/JP
  • 7Department Of Respiratory Medicine, Saitama Medical University, Saitama/JP
  • 8Biostatistics And Epidemiology, Yokohama City University Medical Center, Yokohama/JP
  • 9Medical Commisioner, South Miyagi Medical Center, 9891253 - Miyagi/JP
  • 10Nippon Medical School, Tokyo/JP

Abstract

Background

In the NEJ002 study comparing first-line gefitinib to a standard-chemotherapy of carboplatin plus paclitaxel for advanced NSCLC patients with tumors harboring sensitive EGFR mutations, progression-free survival was significantly longer in the gefitinib group compared with the standard-chemotherapy group. However, as 98% of the patients in whom first-line carboplatin-paclitaxel failed crossed over to gefitinib therapy, the overall survival was similar between the two groups. The 2.5-year survival rate of both groups in NEJ002 were very good at about 50%. In order to clarify the factors which contribute to the long-term survival of NSCLC patients with mutated EGFR, we evaluated any correlation between demographic factors and overall survival outcome in 230 patients enrolled in NEJ002.

Methods

The analysis was performed independently from our previous reports. A total of 226 patients who received EGFR-tyrosine kinase inhibitors (TKI) and had survival confirmation were analyzed. Fourteen factors were evaluated using the cause-specific survival, and uni- and multi-variate analyses were conducted by Cox's proportional hazard model.

Results

Four prognostic factors were identified by univariate analysis: base-line performance status (PS), existence of the distant metastasis, response to standard-chemotherapy and EGFR-TKI (P < 0.05). There were no significant differences among age, sex, smoking status, histologic type, clinical stage, EGFR mutation type and the assigned treatment groups. Three independent prognostic factors were identified by multivariate analysis: PS 1 [hazard ratio 1.64: 95% CI 1.14-2.36] and stable disease or progressive disease as response to standard-chemotherapy [HR 2.29 : 95% CI 1.31-4.02] and to EGFR-TKI [HR 3.18 : 95% CI 2.01-4.00].

Conclusion

Base-line PS, responses to standard chemotherapy and response to EGFR-TKI were significant factors on the prognosis of NSCLC with sensitive EGFR mutations. Using updated survival data, a logistic regression analysis for long survivors (more than 3 years) will be presented.

Disclosure

A. Inoue: I was paid lecture fees from AstraZeneca.

S. Oizumi: I was paid an honorarium (AstraZeneca).

K. Hagiwara: I was paid honoraria from AstraZeneca.

A. Gemma: I (my department) received grant for basic research by AstraZeneca as a chief of department.

All other authors have declared no conflicts of interest.