457P - Bisphosphonates enhance effect of EGFR-TKIs in NSCLC patients with EGFR mutation and bone metastases

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Anticancer agents
Biomarkers
Supportive Measures
Non-Small-Cell Lung Cancer, Metastatic
Presenter tao Jiang
Citation Annals of Oncology (2016) 27 (suppl_9): ix139-ix156. 10.1093/annonc/mdw594
Authors T. Jiang, C. Zhou
  • Medical Oncology, Shanghai Pulmonary Hospital, Tongji University, 200433 - Shanghai/CN

Abstract

Background

Whether bisphosphonates could enhance the treatment outcome of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in non-small-cell lung cancer (NSCLC) patients with EGFR mutation and bone metastases (BM) remains controversial.

Methods

251 NSCLC patients with EGFR mutation and BM were identified. As first-line treatment, 44 patients received EGFR-TKIs alone and 56 patients received EGFR-TKIs plus bisphosphonates therapy.

Results

Comparing to TKIs alone, EGFR-TKIs plus bisphosphonates had significant longer progression-free survival (PFS: 11.5 vs 10.5 months; HR = 0.64, P = 0.030), but similar overall survival (OS: 20.2 vs 20.8 months; HR = 0.95, P = 0.847) in NSCLC with EGFR mutation and BM. Although the incidence of skeletal-related events in combined treatment group was lower than that in EGFR-TKIs alone group, there is no statistical significance (32.1% vs. 45.5%, P = 0.173). Chemotherapy plus bisphosphonates had similar PFS (6.4 VS 6.7 months; HR = 1.09, P = 0.684) and OS (15.5 vs 14.1 months; HR = 0.87, P = 0.486) to chemotherapy alone in patients with EGFR of wild type. In multivariate analysis, EGFR mutation was found to be a significant independent prognostic factor for OS in NSCLC patients with BM (HR = 0.722, P = 0.019).

Conclusions

In conclusion, the addition of bisphosphonates to EGFR-TKIs could enhance the effect of EGFR-TKIs in NSCLC patients with EGFR mutation and BM. Bisphosphonates did not bring additional benefit to chemotherapy in BM patients with EGFR of wild type. EGFR mutation was the significant independent prognostic factor for OS in NSCLC patients with BM.

Clinical trial indentification

None

Legal entity responsible for the study

N/A

Funding

National Natural Science Foundation of China

Disclosure

All authors have declared no conflicts of interest.