Outcomes After Surgical Resection of Early-stage Lung Adenocarcinomas With Epidermal Growth Factor Receptor Mutations

被引：5

作者：

Chow, Oliver S.

Villena-Vargas, Jonathan

Nasar, Abu

Sun, Brian

Harrison, Sebron

Lee, Benjamin

Port, Jeffrey L.

Altorki, Nasser K.

Stiles, Brendon M.

机构：

[1] New York Presbyterian Queens, Weill Cornell Med, Dept Cardiothorac Surg, New York, NY USA

[2] Montefiore Med Ctr, Albert Einstein Coll Med, Dept Cardiothorac & Vasc Surg, Bronx, NY 10467 USA

来源：

ANNALS OF THORACIC SURGERY | 2022年 / 114卷 / 03期

关键词：

CANCER; PLACEBO;

D O I：

10.1016/j.athoracsur.2021.07.077

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Routine mutation profiling for resected lung cancers is not widespread despite an increasing array of targeted therapies. We report the incidence of epidermal growth factor receptor mutations (EGFRmu+) in resected lung adenocarcinomas and their outcomes at a large North American cancer center to characterize this population now eligible for targeted adjuvant therapy. METHODS Among 1036 pulmonary resections performed between 2015 and 2019, 647 patients (62%) had adeno-carcinomas that underwent molecular profiling by next-generation sequencing. Clinical and pathologic characteristics, along with survival, were analyzed. RESULTS EGFRmu+ were identified in 238 patients (37%). Patients with EGFRmu+ were more likely to be Asian than those with EGFR wild-type (79/238 [33%] vs 37/409 [9%], respectively; P < .001) and more likely to be never-smokers (115/238 [48%] vs 73/409 [18%], P < .001). However, most patients with EGFRmu+ in our cohort were White (45%) and had a history of smoking (52%). A statistically nonsignificant trend was observed toward improved 3-year overall survival for pathologic stage IB to III cancers with EGFRmu+ (91% vs 77%, P [ .09). Patients with pathologic stage IB lung cancers with EGFRmu+ had a 97% rate of 3-year disease-free survival, with only 1 recurrence in the first 3 years of follow-up. EGFR mutation subtype was not associated with survival differences. CONCLUSIONS Although Asians and never-smokers comprised a disproportionately large group of patients with lung adenocarcinomas with EGFRmu+, most EGFR mutations within our cohort were found in patients who were White or with a smoking history, supporting a routine rather than selective approach to mutation profiling. Patients with surgically resected stage IA and IB lung adenocarcinomas enjoy excellent survival regardless of their mutational status.(Ann Thorac Surg 2022;114:905-10)(c) 2022 by The Society of Thoracic Surgeons

引用

页码：905 / 910

页数：6

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