Abstract 1535
Background
EGFR mutation is the major driver mutation in East Asian lung cancer. By and large, this group of lung cancer patients has a better prognosis in advanced stage pulmonary adenocarcinoma. However, the prognostic role of these sensitizing EGFR mutations in early stage is uncertain. We aimed to investigate the prognostic value of EGFR mutation and other factors for tumor recurrence in completely resected LNNPA.
Methods
We recruited 220 patients with LNNPA who were diagnosed and treated at the King Chulalongkorn Memorial Hospital from January 1, 2009 to December 31, 2016. Recurrence included pathological diagnosis, imaging confirmations, or death. Recurrence-free survival was analyzed by univariable and multivariable Cox regression analyses.
Results
Median follow up time was 4 (2.7-5.6) years. There were more female (62%), never smokers (68%), stage I (86%) and EGFR mutations (54%). The most common EGFR mutations were exon 19 deletion (51%) and L858R (43%). Most patients did not receive adjuvant treatment (85.6%). There were 60 out of 220 (27.3%) patients had recurrent disease. The median time to recurrence was 2.3 years. The rate of loco-regional, distant and both types of recurrence were 27%, 68% and 5% respectively. Univariate analysis revealed smoking ≥ 10 pack-year, performance status ≥ 2, tumor size ≥ 4 cm, histologic grade ≥ 2, lymphovascular invasion, visceral pleural invasion, tumor necrosis and bronchial resection margin (BRM) < 2 cm were significant prognostic factors for tumor recurrence. However, tumor size ≥ 4 cm, visceral pleural invasion, tumor necrosis and BRM < 2 cm remained the significant prognostic factors with multivariate analysis (Table). Sensitizing EGFR mutation was not a significant prognostic factor in this cohort by both univariate and multivariate analyses.Table: 1451P
Multivariate analysis
Covariate | HR | 95% CI | P-value |
---|---|---|---|
Tumor size ≥ 4 cm | 1.96 | 1.1 - 3.6 | 0.03 |
Visceral Pleural invasion | 2.38 | 1.3 - 4.3 | 0.004 |
< 2 cm of bronchial resection margin | 2.48 | 1.4 - 4.3 | 0.002 |
Tumor necrosis | 3.12 | 1.7 - 5.6 | < 0.001 |
EGFR mutation | 1.23 | 0.6 - 2.7 | 0.57 |
Conclusions
Among Thai, East Asian, early stage lung cancer, sensitizing EGFR mutation has similar outcomes to those without EGFR mutation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Ratchadapisek Sompoch Endowment Fund.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2935 - Correlation of progression free survival-2 and overall survival in solid tumors
Presenter: Paul Mainwaring
Session: Poster Display session 1
Resources:
Abstract
2273 - High performance of serial tumor biopsies in first in human (FIH) phase I trials.
Presenter: Jun Sato
Session: Poster Display session 1
Resources:
Abstract
5933 - Response rates and lesion-level progression patterns of solid tumor patients in an academic phase 1 program: implications for tumor heterogeneity
Presenter: Christopher Chen
Session: Poster Display session 1
Resources:
Abstract
3569 - Clinical Benefit and Response Rate in Early Phase Clinical Trials: First Report from a Single-Institution Study
Presenter: Antonio Marra
Session: Poster Display session 1
Resources:
Abstract
4139 - Patient (pt) selection for immunotherapeutic early-phase clinical trials (ieCTs): a single Phase I Unit experience
Presenter: Matteo Simonelli
Session: Poster Display session 1
Resources:
Abstract
4451 - Improving patient selection for immuno-oncology phase 1 trials: an external validation of five prognostic scores at Claudius Regaud Institute of Toulouse, Oncopôle (IUCT-O).
Presenter: Ghassan Al Darazi
Session: Poster Display session 1
Resources:
Abstract
1696 - Demonstrating the Changing Trends in Phase 1 Clinical Trials
Presenter: Christina Guo
Session: Poster Display session 1
Resources:
Abstract
3202 - Participation of Women in phase 1 oncology clinical trials
Presenter: Laura Vidal
Session: Poster Display session 1
Resources:
Abstract
4518 - Predictors for early trial discontinuation of patients with cancer participating in phase I clinical trials
Presenter: Joeri Douma
Session: Poster Display session 1
Resources:
Abstract
4368 - Safety of Tumor Treating Fields delivery to the torso: Meta analysis from TTFields clinical trials
Presenter: Federica Grosso
Session: Poster Display session 1
Resources:
Abstract