Cancer Res Treat.  2016 Jul;48(3):1110-1119. 10.4143/crt.2015.289.

Clinical Characteristics and Continued Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Administration in EGFR-mutated Non-Small Cell Lung Cancer with Skeletal Metastasis

• Hong SH
• Kim YS
• Lee JE
• Kim IH
• Kim SJ
• Han D
• Yoo IR
• Chung YG
• Kim YH
• Lee KY
• Kang JH

• KMID: 2344085
• DOI: http://doi.org/10.4143/crt.2015.289

Abstract

PURPOSE
The aim of this study was to analyze clinical characteristics of skeletal metastasis in epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) and treatment outcomes of continued EGFR tyrosine kinase inhibitor (TKI) therapy in patients presenting with skeletal metastasis progression.
MATERIALS AND METHODS
Of the 216 patients treated with EGFR-TKI for management of stage III-IV NSCLC between 2006 and 2012 in Seoul St. Mary's Hospital, 76 patients with confirmed EGFR-mutated NSCLC with skeletal metastases during therapy were analyzed retrospectively.
RESULTS
Of 76 patients with EGFR mutant lung cancer with skeletal metastasis, 37 patients developed first progressive disease (PD) in skeletal regions. EGFR-TKI was continued in these 37 patients after first PD in skeletal regions. Median time to first PD of skeletal regions was 8.9 months (95% confidence interval [CI], 4.8 to 13.0). Median time of continued EGFR-TKI after first PD of skeletal regions was 8.0 months (95% CI, 2.9 to 13.0) in patients with disease progression of preexisting regions, 5.6 months (95% CI, 4.5 to 6.7) in patients showing new localized regions, and 3.3 months (95% CI, 1.1 to 5.5) in patients with multiple new metastatic regions (p=0.006). Median time of postskeletal metastasis progression survival was 23.0 months (95% CI, 13.5 to 32.5), 15.0 months (95% CI, 3 to 34.7), and 7.0 months (95% CI, 6.0 to 8.0) (p=0.004) in the above described patient groups, respectively. Overall, seven patients (18.9%) had more than one episode of skeletal progression of disease without extraskeletal PD.
CONCLUSION
Continued EGFR-TKI treatment with adequate local treatment after progression of skeletal metastasis may be considered for patients who show disease progression in preexisting regions or local progression.

Keyword

EGFR; Non-small cell lung carcinoma; EGFR tyrosine kinase inhibitor; Bone metastasis; Response Evaluation Criteria in Solid Tumors

MeSH Terms

Carcinoma, Non-Small-Cell Lung*
Disease Progression
Epidermal Growth Factor*
Humans
Lung Neoplasms
Neoplasm Metastasis*
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor*
Response Evaluation Criteria in Solid Tumors
Retrospective Studies
Seoul
Epidermal Growth Factor
Protein-Tyrosine Kinases
Receptor, Epidermal Growth Factor

Figure

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  Fig. 1. Median overall survival time of patients who continued epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy and patients who discontinued EGFR-TKI therapy after progressive disease (PD).

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  Fig. 2. (A) Median time of continued epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) after first progressive disease for patient groups according to patterns of progression in skeletal metastasis. (B) Postskeletal metastasis progression survival for patient groups according to patterns of progression in skeletal metastasis.

Reference

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