Abstract 12P
Background
Lung cancer has the highest incidence and mortality among all cancers, with a 5-year survival rate of 15%. Presently, epidermal growth factor receptor (EGFR) mutation is the most common type of gene mutations detected in patients (pts) with advanced non-small-cell lung cancer, and EGFR is identified as the therapeutic target of EGFR tyrosine kinase inhibitors (TKIs). EGFR-TKIs have become the standard treatment. However, the most of the trials were developed in Asian countries, with a lack of data in western population.
Methods
This retrospective study aimed to review the medical records of EGFR- mutant advanced lung adenocarcinoma (LA) undergoing EGFR-TKIs treatment from 2015 to 2021, so as to examine the association of clinical factors with EGFR-TKI efficacy.
Results
Of the 53 stage IV LA pts enrolled in this study, 9 were treated with more than one TKI. The mean age was 74,2 years old, 32 pts were non-smoker females and 38 had ECOG-PS 0-1. The mutations del19 or 21 L861G were the most frequent (23 and 20 pts respectively). The 20 T790M mutation was detected in 6 pts. First-line TKI (Gefitinib, Afatinib, Erlotinib and Osimertinib) were used in 26 pts and prior chemotherapy was preferred in 29 pts. A 24% objective response rate (ORR) and 67% disease control rate were observed for EGFR-TKIs treatment in all lines. Higher ORR was seen in patients with 0/1 ECOG scores than those with 2 or greater scores (p=0.046). The subjects had a progression free survival (PFS) of 17,8 months (p<0,01; 95% CI:12.9-22.84) and an overall survival (OS) of 27,5 months (p<0.01; 95% CI: 18.27-36.823). The median PFS was longer in pts treat with first-line TKI (p=0.029). The multivariate analysis indicated that ECOG-PS (p=0.04) and bone metastasis (p=0.036) were independent prognostic factors for OS.
Conclusions
The EGFR-TKI therapy results in survival benefits for EGFR-mutant advanced LA patients. ECOG-PS and bone metastasis were independent prognostic factors for OS.
Legal entity responsible for the study
Hospital Professor Doutor Fernando Fonseca.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.