1356P - 10-year survivors treated with tyrosine kinase inhibitor for advanced non-small cell lung cancer

Background

The development of tyrosine kinase inhibitors (TKI) has led to the emergence of long-term survivors in advanced non-small cell lung cancer (NSCLC), with a part of them surviving more than 5 years. However, no studies have examined the 10-year survivor in patients (pts) with advanced NSCLC receiving TKI. This study aims to clarify characteristics of the 10-year survivors.

Methods

We have retrospectively reviewed the clinico-genomic findings of advanced or recurrent NSCLC pts with driver oncogene who received TKIs at the National Cancer Center Hospital East between 2002 and 2012. We defined pts who survived more than 10 years as the long survivor group and others as the non-long survivor group.

Results

The analysis included 387 pts. The survival rate at the 5- and 10-year were 21% and 7%. 27 pts (7%) were in the long survivor group and 360 pts (93%) were in the non-long survivor group. The types of driver alterations were as follows: 358 EGFR mutations, 24 ALK fusions, 4 ROS1 fusions and 1 RET fusion. A comparison analysis between long survivor and non-long survivor showed that the median age was 60 (range 23-89) vs. 64 (range 25-84) (P = 0.005); female was 22 (81%) vs. 213 (59%) (P = 0.02); ECOG-PS 0-1 was 27 (100%) vs. 334 (93%) (P = 0.24) ; never smoker was 18 (67%) vs. 195 (54%) (P = 0.23); fusion genes were 5 (19%) vs. 24 (7%) (P = 0.04). Among EGFR-mutated pts, there were no differences in the fraction of EGFR mutation subtypes between the two groups. The proportion of deaths from non-lung cancer including cardiovascular disease and other site of cancer after 5 and 10 years was 7% and 33%, and pts survived longer than 10 years had a higher proportion of deaths from non-lung cancer compared to the others (P = 0.01).

Conclusions

10-year survivors had characteristics of younger age, female, and with fusion alterations, while there are no difference EGFR subtype. Despite achieving 5-year survival, two-thirds did not achieve 10-year survival. The increase of deaths from non-lung cancer in the long-term survivor, emphasizing the importance of monitoring and managing cardiovascular and other cancer complications.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

H. Izumi: Financial Interests, Institutional, Local PI: Amgen Inc, Eisai, AbbVie; Financial Interests, Personal and Institutional, Local PI, Invited Speaker: Ono Pharmaceutical Company, AstraZeneca; Financial Interests, Personal, Other, Invited Speaker: Chugai Pharmaceutical Co., Merck Biopharma Co., Takeda Pharmaceutical Co.; Financial Interests, Personal, Other, Advisory board: Amgen. Y. Zenke: Financial Interests, Personal, Invited Speaker: AstraZeneca, Lilly, Chugai, Boehringer-Ingelheim, Ono Pharmaceutical, Bristol Myers Squibb, Takeda Pharmaceutical, Taiho Pharmaceutical, MSD, Novartis, Nippon-Kayaku, Amgen, Kyowa-Hakko Kirin; Financial Interests, Personal, Advisory Board: Daiichi Sankyo; Financial Interests, Institutional, Research Grant: AstraZeneca, MSD, Merck, Daiichi Sankyo, Amgen. S. Matsumoto: Financial Interests, Personal, Invited Speaker: Merck Biopharma, Eli Lilly, AstraZeneca, Chugai, Novartis, Guardant Health, Amgen, Takeda; Financial Interests, Institutional, Local PI: Merck Biopharma, Janssen Pharmaceutical K.K., MSD. K. Yoh: Financial Interests, Personal, Invited Speaker: AstraZeneca, Bristol Myers Squibb, Chugai, Daiichi Sankyo, Lilly, Boehringer Ingelheim, Amgen, Takeda; Financial Interests, Institutional, Local PI: AstraZeneca, Lilly, Daiichi Sankyo, AbbVie, Taiho, MSD, Takeda, Amgen, Boehringer Ingelheim, Chugai; Financial Interests, Personal, Steering Committee Member: AstraZeneca. K. Goto: Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical Co., Ltd., Amgen K.K., Takeda Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Amgen Inc., Amoy Diagnostics Co.,Ltd., AstraZeneca K.K., Bayer HealthCare Pharmaceuticals Inc., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb K.K., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Guardant Health Inc., Merck Biopharma Co., Ltd., Novartis Pharma K.K., Ono Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd., Thermo Fisher Scientific K.K., Taiho Pharmaceutical Co., Ltd., Syneos Health Clinical K.K., Life Technologies Japan Ltd.; Financial Interests, Personal, Advisory Board: Janssen Pharmaceutical K.K., Medpace Japan K.K., Haihe Biopharma Co., Ltd.; Financial Interests, Personal and Institutional, Funding: Amgen Inc., Amgen K.K., AstraZeneca K.K., Boehringer Ingelheim Japan, Inc., Bristol Myers Squibb K.K., Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Eisai Co., Ltd., Eli Lilly Japan K.K., Haihe Biopharma Co., Ltd., Ignyta, Inc., Janssen Pharmaceutical K.K., Kissei Pharmaceutical Co., Ltd., Kyowa Kirin Co., Ltd., Loxo Oncology, Inc., Medical ＆ Biological Laboratories Co., Ltd., Merck Biopharma Co., Ltd., Merus N.V., MSD K.K., Ono Pharmaceutical Co., Ltd., Pfizer Japan Inc., Sysmex Corporation., Taiho Pharmaceutical Co., Ltd., Bayer Yakuhin, Ltd., Takeda Pharmaceutical Co., Ltd., Turning Point Therapeutics, Inc., Amgen Astellas BioPharma K.K., Blueprint Medicines Corporation., Life Technologies Japan Ltd., NEC Corporation., Novartis Pharma K.K., Craif Inc., Pfizer R&D Japan G.K., Turning Point Therapeutics, Inc.; Non-Financial Interests, Member: American Society of Clinical Oncology, The Japan Lung Cancer Society, Japanese Society of Medical Oncology, The Japanese Cancer Association. All other authors have declared no conflicts of interest.