Prognostic impact of pleural effusion in EGFR-mutant non-small cell lung cancer patients without brain metastasis

© 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd..

BACKGROUND: In epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), brain metastasis is known as a poor prognosis factor. However, prognostic factors in the patients without brain metastasis remain unclear. In this study, we aimed to clarify the differences between metastatic site and prognosis in common EGFR-mutant NSCLC patients without brain metastasis.

METHODS: Chemotherapy-naïve, advanced EGFR-mutant NSCLC patients without brain metastasis diagnosed between January 2010 and March 2016 were enrolled. We evaluated prognosis according to the presence or absence of bone metastases, liver metastasis, and pleural effusion.

RESULTS: A total of 50 EGFR-mutant NSCLC patients without brain metastasis were enrolled. The median progression-free survival and overall survival were significantly shorter in patients with pleural effusion than in those patients without (progression-free survival 7.0 months, 95% confidence interval [CI] 3.7-13.0 vs. 13.0 months, 95% CI 9.1-21.7, hazard ratio [HR] 2.29, 95% CI 1.11-4.73, P = 0.020; overall survival 19.5 months, 95% CI 5.7-28.8 vs. 55.3 months, 95% CI 24.0-not evaluable, HR 3.00, 95% CI 1.35-6.68, P = 0.005). Pleural effusion was an independent factor of poor prognosis for progression-free survival (HR 3.44, 95% CI 1.50-7.88, P = 0.003) and overall survival (HR 2.34, 95% CI 1.00-5.44, P = 0.049).

CONCLUSION: Pleural effusion might be a poor prognosis factor for advanced EGFR-mutant NSCLC patients without brain metastasis treated with first-generation EGFR-tyrosine kinase inhibitors. Further precision medicine according to the metastatic site is required.

Media Type:

Electronic Article

Year of Publication:

2019

Contained In:

Thoracic cancer - Vol. 10, No. 3 (2019), p. 557-563

Language:

English

Contributors:

Yoshimura, Akihiro
Yamada, Tadaaki
Tsuji, Taisuke
Hamashima, Ryosuke
Shiotsu, Shinsuke
Yuba, Tatsuya
Takumi, Chieko
Uchino, Junji
Hiraoka, Noriya
Takayama, Koichi

Links:

Volltext

Keywords:

Adult
Aged
Aged, 80 and over
Brain Neoplasms
Carcinoma, Non-Small-Cell Lung
Disease Progression
EC 2.7.10.1
EGFR protein, human
Epidermal growth factor receptor
ErbB Receptors
Female
Gefitinib
Humans
Journal Article
Male
Metastasis
Middle Aged
Mutation
Neoplasm Metastasis
Non-small cell lung cancer
Pleural Effusion
Pleural effusion
Prognosis
Prognosis factor
Progression-Free Survival
Proportional Hazards Models
Protein Kinase Inhibitors
S65743JHBS

Notes:

Date Completed 04.03.2020

Date Revised 09.03.2020

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1111/1759-7714.12979

PMID:

30672656

PPN (Catalogue-ID):

NLM293503567