EGFR mutated non-small cell lung cancer patients: More prone to development of bone and brain metastases?

被引：153

作者：

Hendriks, L. E. L. ^{[1
]}

Smit, E. F. ^{[2
]}

Vosse, B. A. H. ^{[1
]}

Mellema, W. W. ^{[2
]}

Heideman, D. A. M. ^{[3
]}

Bootsma, G. P. ^{[4
]}

Westenend, M. ^{[5
]}

Pitz, C. ^{[6
]}

de Vries, G. J. ^{[7
]}

Houben, R. ^{[8
]}

Grunberg, K. ^{[3
]}

Bendek, M. ^{[9
]}

Speel, E-J M. ^{[9
]}

Dingemans, A-M C. ^{[1
]}

机构：

[1] Maastricht Univ Med Ctr, Dept Pulm Dis, NL-6202 AZ Maastricht, Netherlands

[2] Vrije Univ Amsterdam Med Ctr, Dept Pulm Dis, NL-1007 MB Amsterdam, Netherlands

[3] Vrije Univ Amsterdam Med Ctr, Dept Pathol, NL-1007 MB Amsterdam, Netherlands

[4] Atrium Med Ctr, Dept Pulm Dis, NL-6419 PC Heerlen, Netherlands

[5] VieCuri, Dept Pulm Dis, NL-5912 BL Venlo, Netherlands

[6] Laurentius Hosp, Dept Pulm Dis, NL-6043 CV Roermond, Netherlands

[7] Orbis Med Ctr, Dept Pulm Dis, NL-6130 MB Sittard, Netherlands

[8] Maastricht Univ Med Ctr, GROW Sch Oncol & Dev Biol, Dept Radiat Oncol MAASTRO, NL-6202 NA Maastricht, Netherlands

[9] Maastricht Univ Med Ctr, GROW Sch Oncol & Dev Biol, Dept Pathol, NL-6202 AZ Maastricht, Netherlands

来源：

LUNG CANCER | 2014年 / 84卷 / 01期

关键词：

NSCLC; EGFR; KRAS; Brain metastases; Bone metastases; Survival; TYROSINE KINASE INHIBITORS; FACTOR RECEPTOR MUTATIONS; DOSE WEEKLY ERLOTINIB; RADIOTHERAPY; GEFITINIB; SURVIVAL; ADENOCARCINOMA; THERAPY; DISEASE; IMPACT;

D O I：

10.1016/j.lungcan.2014.01.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 [肿瘤学];

摘要：

Objectives: Both bone and brain are frequent sites of metastasis in non-small cell lung cancer (NSCLC). Conflicting data exist whether EGFR mutant (+) patients are more prone to develop brain metastases or have a better outcome with brain metastases compared to EGFR/KRAS wildtype (WT) or KRAS+ patients. For bone metastases this has not been studied. Methods: In this retrospective case-control study all EGFR+ (exons 19 and 21) patients diagnosed at two pathology departments were selected (2004/2008 to 2012). For every EGER+ patient a consecutive KRAS+ and WT patient with metastatic NSCLC (mNSCLC) was identified. Patients with another malignancy within 2 years of mNSCLC diagnosis were excluded. Data regarding age, gender, performance score, histology, treatment, bone/brain metastases diagnosis, skeletal related events (SRE) and subsequent survival were collected. Results: 189 patients were included: 62 EGFR+, 65 KRAS+, 62 WT. 32%, 35% and 40%, respectively, had brain metastases (p = 0.645). Mean time to brain metastases was 20.8 [+/- 12.0], 10.8 [+/- 9.8], 16.4 [+/- 10.2] months (EGFR+-KRAS+, p = 0.020, EGFR+-WT, p = 0.321). Median post brain metastases survival was 12.1 [5.0-19.1], 7.6 [1.2-14.0], 10.7 [1.5-19.8] months (p = 0.674). 60%, 52% and 50% had metastatic bone disease (p = 0.528). Mean time to development of metastatic bone disease was 13.4[+/- 10.6], 23.3 [+/- 19.4], 16.4 [+/- 9.6] months (p = 0.201). Median post metastatic bone disease survival was 15.0 [10.6-203], 9.0 [5.2-12.9],3.2 [0.0-6.9] months (p = 0.010). Time to 1st SRE was not significantly different. Conclusions: Incidence of brain and bone metastases was not different between EGER+, KRAS+ and WT patients. Post brain metastases survival, time from mNSCLC diagnosis to metastatic bone disease and 1st SRE did not differ either. Post metastatic bone disease survival was significantly longer in EGFR+ patients. Although prevention of SRE's is important for all patients, the latter finding calls for a separate study for SRE preventing agents in EGFR+ patients. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

引用

页码：86 / 91

页数：6

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