- Email: [email protected]
Egfr Mutation and Survival Outcomes in Patients with Completely Resected Lung Adenocarcinoma – a Multiple Centers, Non-Interventional Study (Ican Trial)
Annals of Oncology 25 (Supplement 4): iv409–iv416, 2014 doi:10.1093/annonc/mdu347.3
1175O
EGFR MUTATION AND SURVIVAL OUTCOMES IN PATIENTS WITH COMPLETELY RESECTED LUNG ADENOCARCINOMA – A MULTIPLE CENTERS, NON-INTERVENTIONAL STUDY (ICAN TRIAL)
significant association with 3-year DFS, while age, smoking pack-years didn’t show statistically significant associations with 3-year DFS. Disclosure: Y. Wu: Recieved speaker fees from AstraZeneca, Roche, Eli Lilly, Sanofi, Pfizer. All other authors have declared no conflicts of interest.
Aim: ICAN study (NCT01106781) was designed to investigate EGFR gene mutation status, clinical outcomes and recurrent risk factors in early stage Chinese NSCLC patients with adenocarcinoma (ADC) histology after complete resection. Methods: Patients were ≥18 years old, with histological diagnosis of NSCLC ADC, and received surgical complete resection. Tumor sample EGFR mutation status was determined according to clinical routine practice. All eligible patients were followed up for 3 years to collect the clinical information and the survival outcomes. Results: Of 568 patients from 26 sites, 313 (55.1%) patients were EGFR mutation positive. The most common mutations were exon19 deletion and exon 21 L858R mutation found in 139 (24.5%) and 128 (22.5%) patients respectively. 4(0.7%) patients were exon19 deletion + exon 21 L858R mutations and 42 (7.4%) patients were with rare mutations. Frequency of EGFR mutation was not correlated to postoperative pathological stage (P = 0.1047). The 3-year DFS was 58.8%. Subgroup analysis found that 65.6% 3y DFS in EGFR mutant patients and 56.8% in wild type patients (P = 0.0347); 63.8% in exon 19 deletion, 67.2% in exon21 L858R mutation, 100% in exon19 deletion + exon 21 L858R mutations and 63.4% in rare mutations (p = 0.5810). There were 50.7% of the patients who received adjuvant therapy, among which 45.4% received chemotherapy, 4.6% received radiotherapy and 1.8% received TKI therapy, respectively. Among EGFR mutant patients, adjuvant therapy correlated significantly to 3-year DFS (P = 0.0024), but was not significant when adjusted for postoperative pathological stage. Female showed a higher 3-year DFS rate than male patients (67.90% vs 55.70%, P = 0.0041). There was statistically significant difference of 3-year DFS among patients with different postoperative pathologic stage (P <0.0001). Factors not statistically correlated to 3-year DFS rate were age (P = 0.3400) and smoking pack-years (P = 0.3727). Conclusions: The overall EGFR mutation positive rate in operable Chinese ADC was 55.1%. 3-year DFS rate was 58.8%. EGFR mutant patients have a favorable 3-year DFS compared with EGFR wild type. Postoperative pathologic stage had a statistically
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from http://annonc.oxfordjournals.org/ by guest on October 18, 2015
Y. Wu1, X. Chu2, J. Wang3, Z. Liu4, Y. Shen5, H. Ma6, X. Fu7, J. Hu8, N. Zhou9, Y. Liu10, X. Zhou11, J. Wang12, K. Yang13, J. Li14, L. Xu15, S. Wang16, Q. Wang17, L. Liu18, S. Xu19, X. Zhang20 1 Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, CHINA 2 Department of Thoracic Surgery, 301 hospital, Beijing, CHINA 3 Department of Thoracic Surgery, People’s Hospital of Peking University, Beijing, CHINA 4 Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, CHINA 5 Department Thoracic Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao, CHINA 6 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, CHINA 7 Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINA 8 Department of Thoracic Surgery, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, CHINA 9 Department of Thoracic Surgery, 309 Hospital, Beijing, CHINA 10 Department of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang, CHINA 11 Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, CHINA 12 Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINA 13 Department of Thoracic Surgery, The First Affiliated Hospital of Third Military Medical University, Chongqing, CHINA 14 Department of Thoracic Surgery, Peking University First Hospital, Beijing, CHINA 15 Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, CHINA 16 Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, CHINA 17 Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, CHINA 18 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chongqing, CHINA 19 Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, CHINA 20 Guangdong Lung Cancer Institute, Medical Research Center of Guangdong General Hospital, Guangzhou, CHINA
abstracts
NSCLC, early stage
1175O
EGFR MUTATION AND SURVIVAL OUTCOMES IN PATIENTS WITH COMPLETELY RESECTED LUNG ADENOCARCINOMA – A MULTIPLE CENTERS, NON-INTERVENTIONAL STUDY (ICAN TRIAL)
significant association with 3-year DFS, while age, smoking pack-years didn’t show statistically significant associations with 3-year DFS. Disclosure: Y. Wu: Recieved speaker fees from AstraZeneca, Roche, Eli Lilly, Sanofi, Pfizer. All other authors have declared no conflicts of interest.
Aim: ICAN study (NCT01106781) was designed to investigate EGFR gene mutation status, clinical outcomes and recurrent risk factors in early stage Chinese NSCLC patients with adenocarcinoma (ADC) histology after complete resection. Methods: Patients were ≥18 years old, with histological diagnosis of NSCLC ADC, and received surgical complete resection. Tumor sample EGFR mutation status was determined according to clinical routine practice. All eligible patients were followed up for 3 years to collect the clinical information and the survival outcomes. Results: Of 568 patients from 26 sites, 313 (55.1%) patients were EGFR mutation positive. The most common mutations were exon19 deletion and exon 21 L858R mutation found in 139 (24.5%) and 128 (22.5%) patients respectively. 4(0.7%) patients were exon19 deletion + exon 21 L858R mutations and 42 (7.4%) patients were with rare mutations. Frequency of EGFR mutation was not correlated to postoperative pathological stage (P = 0.1047). The 3-year DFS was 58.8%. Subgroup analysis found that 65.6% 3y DFS in EGFR mutant patients and 56.8% in wild type patients (P = 0.0347); 63.8% in exon 19 deletion, 67.2% in exon21 L858R mutation, 100% in exon19 deletion + exon 21 L858R mutations and 63.4% in rare mutations (p = 0.5810). There were 50.7% of the patients who received adjuvant therapy, among which 45.4% received chemotherapy, 4.6% received radiotherapy and 1.8% received TKI therapy, respectively. Among EGFR mutant patients, adjuvant therapy correlated significantly to 3-year DFS (P = 0.0024), but was not significant when adjusted for postoperative pathological stage. Female showed a higher 3-year DFS rate than male patients (67.90% vs 55.70%, P = 0.0041). There was statistically significant difference of 3-year DFS among patients with different postoperative pathologic stage (P <0.0001). Factors not statistically correlated to 3-year DFS rate were age (P = 0.3400) and smoking pack-years (P = 0.3727). Conclusions: The overall EGFR mutation positive rate in operable Chinese ADC was 55.1%. 3-year DFS rate was 58.8%. EGFR mutant patients have a favorable 3-year DFS compared with EGFR wild type. Postoperative pathologic stage had a statistically
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from http://annonc.oxfordjournals.org/ by guest on October 18, 2015
Y. Wu1, X. Chu2, J. Wang3, Z. Liu4, Y. Shen5, H. Ma6, X. Fu7, J. Hu8, N. Zhou9, Y. Liu10, X. Zhou11, J. Wang12, K. Yang13, J. Li14, L. Xu15, S. Wang16, Q. Wang17, L. Liu18, S. Xu19, X. Zhang20 1 Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, CHINA 2 Department of Thoracic Surgery, 301 hospital, Beijing, CHINA 3 Department of Thoracic Surgery, People’s Hospital of Peking University, Beijing, CHINA 4 Thoracic Surgery, Beijing Chest Hospital, Capital Medical University, Beijing, CHINA 5 Department Thoracic Surgery, The Affiliated Hospital of Qingdao University Medical College, Qingdao, CHINA 6 Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, CHINA 7 Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINA 8 Department of Thoracic Surgery, The First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou, CHINA 9 Department of Thoracic Surgery, 309 Hospital, Beijing, CHINA 10 Department of Thoracic Surgery, Liaoning Cancer Hospital & Institute, Shenyang, CHINA 11 Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, CHINA 12 Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, CHINA 13 Department of Thoracic Surgery, The First Affiliated Hospital of Third Military Medical University, Chongqing, CHINA 14 Department of Thoracic Surgery, Peking University First Hospital, Beijing, CHINA 15 Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, CHINA 16 Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, CHINA 17 Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, CHINA 18 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chongqing, CHINA 19 Department of Thoracic Surgery, The First Hospital of China Medical University, Shenyang, CHINA 20 Guangdong Lung Cancer Institute, Medical Research Center of Guangdong General Hospital, Guangzhou, CHINA
abstracts
NSCLC, early stage