Author of

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  P35 - Pathology - Genomics (ID 105)

  • Event: WCLC 2020
  • Type: Posters
  • Track: Pathology, Molecular Pathology and Diagnostic Biomarkers
  • Presentations: 1
  • Moderators:
  • Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall

  • 34737

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    P35.04 - The Prognostic Value of Metastasis to Different Organs in EGFR-Mutated Stage IV NSCLC Patients Treated with First-Line Icotinib (ID 1324)

    00:00 - 00:00  |  Presenting Author(s): Yudong Wang
    • Abstract
    • Slides

    Introduction
    

    Although several studies have revealed the prognostic value of metastasis to certain organs, it has not been defined which metastases predicted the best and worst survival outcomes in non-small cell lung cancer (NSCLC) patients treated with first-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Moreover, whether presence of distant metastasis at initial diagnosis is associated with treatment outcomes remains largely unknown in patients with EGFR-mutated stage IV NSCLC treated with first-line icotinib. This study was conducted to evaluate the impact of metastasis to organs on survival outcomes of stage IV NSCLC patients harboring EGFR mutations receiving first-line icotinib.

    Methods
    

    Total of 216 stage IV NSCLC patients harboring EGFR mutation in exon 18, 19 or 21, who received first-line icotinib treatment, were enrolled between July 2011 and October 2017. The impacts of presence of metastases to organs, including liver, adrenal gland, leptomeninges, brain parenchyma, pericardium, extrathoracic lymph node, lung, pleura, and bone, on progression-free survival (PFS) and overall survival (OS) were analyzed using Kaplan-Meier and Cox proportional hazards model methods.

    Results
    

    Of 216 enrolled patients, presence of metastases to organs was not associate with PFS. In terms of OS, patients with liver metastasis had significantly shorter OS than those without liver metastasis (14.6 months vs. 33.0 months, p=0.024), and patients with brain metastasis showed marginally significantly shorter OS than those without brain metastasis (26.5 months vs. 33.8 months, p=0.051); while patients with lung metastasis showed longer OS than those without lung metastasis (36.0 months vs. 28.6 months, p=0.038). Multivariable Cox regression analysis showed presence of liver metastasis (HR[hazard ratio]: 2.265, 95% CI [confidence interval]: 1.239-4.139, p=0.008) and brain metastasis (HR: 1.496, 95% CI: 0.963-2.080, p=0.043) were independent risk factors for OS, and presence of lung metastasis (HR: 0.669, 95% CI: 0.460-0.971, p=0.034) was an independent protective factor for OS. Among patients with liver, brain or lung metastasis, patients with liver metastasis had the worst OS followed by patients with brain metastasis, while patients with lung metastasis had the best OS.

    Conclusion
    

    The presence of liver and brain metastasis predicts unfavorable OS, and lung metastasis predicts favorable OS in EGFR-mutated stage IV NSCLC patients receiving icotinib as first-line setting. Our work provides insight into the prognostic value of presence of metastasis to different organs at diagnosis in EGFR-mutated stage IV NSCLC patients receiving icotinib as first-line setting, which might be helpful for disease management in stratifying patients prior to first-line icotinib treatment.

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