1175O - EGFR mutation and survival outcomes in patients with completely resected lung adenocarcinoma - a multiple centers, non-interventional study (ICAN t...

Date 28 September 2014
Event ESMO 2014
Session NSCLC early stage
Topics Non-Small-Cell Lung Cancer, Early Stage
Pathology/Molecular Biology
Translational Research
Presenter Yi-Long Wu
Citation Annals of Oncology (2014) 25 (suppl_4): iv409-iv416. 10.1093/annonc/mdu347
Authors Y. Wu1, J. Wang2, X. Chu3, Z. Liu4, Y. Shen5, H. Ma6, X. Fu7, J. Hu8, N. Zhou9, Y. Liu10, X. Zhou11, J. Wang12, K. Yang13, J. Li14, L. Xu15, S. Wang16, Q. Wang17, L. Liu18, S. Xu19, X. Zhang20
  • 1Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, 510080 - Guangzhou/CN
  • 2Department Of Thoracic Surgery, People’s Hospital of Peking University, 100044 - beijing/CN
  • 3Department Of Thoracic Surgery, 301 hospital, Beijing/CN
  • 4Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, 101149 - Beijing/CN
  • 5Department Thoracic Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao/CN
  • 6Department Of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou/CN
  • 7Department Of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan/CN
  • 8Department Of Thoracic Surgery, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou/CN
  • 9Department Of Thoracic Surgery, 309 Hospital, Beijing/CN
  • 10Department Of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang/CN
  • 11Department Of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou/CN
  • 12Department Of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan/CN
  • 13Department Of Thoracic Surgery, The First Affiliated Hospital of Third Military Medical University, Chongqing/CN
  • 14Department Of Thoracic Surgery, Peking University First Hospital, Beijing/CN
  • 15Department Of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing/CN
  • 16Department Of Thoracic Surgery, Sun Yat-sen university cancer center, Guangzhou/CN
  • 17Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai/CN
  • 18Department Of Thoracic Surgery, West China Hospital, Sichuan University, Chongqing/CN
  • 19Department Of Thoracic Surgery, The First Hospital of China Medical University, Shenyang/CN
  • 20Guangdong Lung Cancer Institute, Medical Research Center of Guangdong General Hospital, Guangzhou/CN

Abstract

Aim

ICAN study (NCT01106781) was designed to investigate EGFR gene mutation status, clinical outcomes and recurrent risk factors in early stage Chinese NSCLC patients with adenocarcinoma (ADC) histology after complete resection.

Methods

Patients were ≥18 years old, with histological diagnosis of NSCLC ADC, and received surgical complete resection. Tumor sample EGFR mutation status was determined according to clinical routine practice. All eligible patients were followed up for 3 years to collect the clinical information and the survival outcomes.

Results

Of 568 patients from 26 sites, 313 (55.1%) patients were EGFR mutation positive. The most common mutations were exon19 deletion and exon 21 L858R mutation found in 139 (24.5%) and 128 (22.5%) patients respectively. 4(0.7%) patients were exon19 deletion + exon 21 L858R mutations and 42 (7.4%) patients were with rare mutations. Frequency of EGFR mutation was not correlated to postoperative pathological stage (P = 0.1047). The 3-year DFS was 58.8%. Subgroup analysis found that 65.6% 3y DFS in EGFR mutant patients and 56.8% in wild type patients (P = 0.0347); 63.8% in exon 19 deletion, 67.2% in exon21 L858R mutation, 100% in exon19 deletion + exon 21 L858R mutations and 63.4% in rare mutations (p = 0.5810). There were 50.7% of the patients who received adjuvant therapy, among which 45.4% received chemotherapy, 4.6% received radiotherapy and 1.8% received TKI therapy, respectively. Among EGFR mutant patients, adjuvant therapy correlated significantly to 3-year DFS (P = 0.0024), but was not significant when adjusted for postoperative pathological stage. Female showed a higher 3-year DFS rate than male patients (67.90% vs 55.70%, P = 0.0041). There was statistically significant difference of 3-year DFS among patients with different postoperative pathologic stage (P <0.0001). Factors not statistically correlated to 3-year DFS rate were age (P = 0.3400) and smoking pack-years (P = 0.3727).

Conclusions

The overall EGFR mutation positive rate in operable Chinese ADC was 55.1%. 3-year DFS rate was 58.8%. EGFR mutant patients have a favorable 3-year DFS compared with EGFR wild type. Postoperative pathologic stage had a statistically significant association with 3-year DFS, while age, smoking pack-years didn't show statistically significant associations with 3-year DFS.

Disclosure

Y. Wu: Recieved speaker fees from AstraZeneca, Roche, Eli Lilly, Sanofi, Pfizer. All other authors have declared no conflicts of interest.