BMC Cancer: Exploring the clinical characteristics of patients with advanced EGFR/ALK-mutated non-small cell lung cancer (NSCLC) surviving more than 5 years

Recently, a study was published in the journal BMC Cancer to evaluate the clinical characteristics and influencing factors of long-term survival in patients with advanced EGFR/ALK-mutated non-small cell lung cancer (NSCLC) when initially treated with chemotherapy
.

177 patients with advanced, EGFR-mutated or ALK-rearranged NSCLC who received their first chemotherapy between December 2008 and September 2015 were included in the study
.

Among the 177 patients, 155 patients were EGFR mutation patients and 22 patients were ALK rearrangement patients
.

• Among patients with EGFR mutations, the median overall duration of EGFR-TKI therapy was 18.
  
  65

  The median OS of patients in the overall population was 40.
  6 months, with a 1-year survival rate of 89%, a 3-year survival rate of 54%, and a 5-year survival rate of 28%
  .

  
  After 72 months, the OS curve plateaued, at which point survival was 20.
  
  

  The log-rank test showed that the OS of the 5 subgroups was significantly different
  .

  
  The variables associated with significantly longer OS were: age less than 75 years (p=0.
  
  

  The subtypes of EGFR mutation patients were exon 19 deletion in 74 patients (47.
  7%), exon 21 L858R mutation in 63 patients (40.
  6%), and exon 18 G719A/C/S in 4 patients (2.
  6%) , exon L861Q had 3 patients
  .

  
  19 There were no statistically significant differences in survival among patients with del, L858R mutation and other subgroups
  
  

  In multivariate analysis using a Cox proportional hazards model, 6 variables were associated with significantly prolonged OS: female gender, age under 75 years, ECOG PS of 0 or 1, ALK rearrangement, postoperative recurrence, and absence of brain metastases
  .
  

  Thirty-seven (23.
  8%) patients with EGFR mutations and 9 (40.
  9%) patients with ALK rearrangements survived for more than 5 years
  .

  
  Of the 37 EGFR-mutant patients, 5 patients had stable disease with only one EGFR-TKI, while 2 patients had stable disease with two EGFR-TKIs
  
  Not only EGFR-TKIs, but also cytotoxic chemotherapy or immunotherapy are used to control their disease
  
  

  Among the 9 patients (40.
  9%) with ALK rearrangement, cases 1, 2, 4, and 9 were treated before the initiation of ALK-TKI, and the first chemotherapy was cytotoxic chemotherapy
  .

  
  Cases 7 and 8 were treated with alectinib
  
  

  Taken together, the study showed that a tailed plateau was found in the long-term survival curves of patients with EGFR-mutated and ALK-rearranged advanced NSCLC, and most patients were receiving treatment, especially for EGFR-mutated NSCLC
  .
  

  A tailed plateau was found in the long-term survival curves of patients with EGFR-mutated and ALK-rearranged advanced NSCLC, and most patients were receiving treatment, especially for EGFR-mutated NSCLC
  .
  

   

  Original source:

  Original source:

  Shimamura SS, Shukuya T, Asao T, Hayakawa D, Kurokawa K, Xu S, Miura K, Mitsuishi Y, Tajima K, Shibayama R, Shimada N, Takahashi F, Takahashi K.
  Survival past five years with advanced, EGFR-mutated or ALK-rearranged non-small cell lung cancer-is there a "tail plateau" in the survival curve of these patients? BMC Cancer.
  2022 Mar 25;22(1):323.
  doi: 10.
  1186/s12885-022-09421-7 .
  PMID: 35337281; PMCID: PMC8953392.
  

  Shimamura SS, Shukuya T, Asao T, Hayakawa D, Kurokawa K, Xu S, Miura K, Mitsuishi Y, Tajima K, Shibayama R, Shimada N, Takahashi F, Takahashi K.
  Survival past five years with advanced, EGFR-mutated or ALK-rearranged non-small cell lung cancer-is there a "tail plateau" in the survival curve of these patients? BMC Cancer.
  2022 Mar 25;22(1):323.
  doi: 10.
  1186/s12885-022-09421-7 .
  PMID: 35337281; PMCID: PMC8953392.
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