Histologic transformation of epidermal growth factor receptor-mutated lung cancer

被引：16

作者：

Fujimoto, Daichi ^{[1
]}

Akamatsu, Hiroaki ^{[1
]}

Morimoto, Takeshi ^{[2
]}

Wakuda, Kazushige ^{[3
]}

Sato, Yuki ^{[4
]}

Kawa, Yoshitaka ^{[5
]}

Yokoyama, Toshihide ^{[6
]}

Tamiya, Motohiro ^{[7
]}

Hiraoka, Ryota ^{[8
]}

Shingu, Naoki ^{[9
]}

Ikeda, Hideki ^{[10
,11
]}

Tamiya, Akihiro ^{[12
]}

Kanazu, Masaki ^{[13
]}

Miyauchi, Eisaku ^{[14
]}

Miura, Satoru ^{[15
]}

Yanai, Masaaki ^{[16
]}

Yomota, Makiko ^{[17
]}

Morinaga, Ryotaro ^{[18
]}

Yokoi, Takashi ^{[19
]}

Hata, Akito ^{[20
]}

Suzuki, Hidekazu ^{[21
]}

Matsumoto, Hirotaka ^{[22
]}

Sakata, Shinya ^{[23
]}

Furuya, Naoki ^{[24
]}

Harutani, Yuhei ^{[25
]}

Nakachi, Ichiro ^{[26
]}

Otsuki, Ayumu ^{[27
]}

Uematsu, Shinya ^{[28
]}

Hara, Satoshi ^{[29
]}

Yokoo, Keiki ^{[30
]}

Sugimoto, Takeya ^{[1
]}

Yamamoto, Nobuyuki ^{[1
]}

机构：

[1] Wakayama Med Univ, Internal Med 3, 811-1 Kimiidera, Wakayama 6418509, Japan

[2] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Hyogo, Japan

[3] Shizuoka Canc Ctr, Div Thorac Oncol, Shizuoka, Japan

[4] Kobe City Med Ctr Gen Hosp, Dept Resp Med, Kobe, Hyogo, Japan

[5] Hyogo Canc Ctr, Dept Thorac Oncol, Akashi, Hyogo, Japan

[6] Kurashiki Cent Hosp, Dept Resp Med, Kurashiki, Okayama, Japan

[7] Osaka Int Canc Inst, Dept Thorac Oncol, Osaka, Japan

[8] Natl Hosp Org Himeji Med Ctr, Dept Resp Med, Himeji, Hyogo, Japan

[9] Saiseikai Kumamoto Hosp, Div Resp Med, Kumamoto, Japan

[10] Chiba Univ, Dept Respirol, Grad Sch Med, Chiba, Japan

[11] Kimitsu Chuo Hosp, Dept Resp Med, Kisarazu, Japan

[12] Natl Hosp Org Kinki Chuo Chest Med Ctr, Dept Internal Med, Sakai, Osaka, Japan

[13] Osaka Toneyarna Med Ctr, Dept Thorac Oncol, Natl Hosp Org, Toyonaka, Osaka, Japan

[14] Tohoku Univ, Dept Resp Med, Grad Sch Med, Sendai, Miyagi, Japan

[15] Niigata Canc Ctr Hosp, Dept Internal Med, Niigata, Japan

[16] Tottori Univ, Fac Med, Div Resp Med & Rheumatol, Yonago, Tottori, Japan

[17] Komagome Hosp, Dept Thorac Oncol & Resp Med, Tokyo Metropolitan Canc & Infect Dis Ctr, Tokyo, Japan

[18] Oita Prefectural Hosp, Dept Thorac Med Oncol, Oita, Japan

[19] Hyogo Coll Med, Dept Thorac Oncol, Nishinomiya, Hyogo, Japan

[20] Kobe Minimally Invas Canc Ctr, Div Thorac Oncol, Kobe, Hyogo, Japan

[21] Osaka Habikino Med Ctr, Dept Thorac Malignancy, Habikino, Japan

[22] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Resp Med, Amagasaki, Hyogo, Japan

[23] Kumamoto Univ Hosp, Dept Resp Med, Kumamoto, Japan

[24] St Marianna Univ, Sch Med, Dept Internal Med, Div Resp Med, Kawasaki, Kanagawa, Japan

[25] Natl Hosp Org Minami Wakayama Med Ctr, Dept Resp Med, Tanabe, Japan

[26] Saiseikai Utsunomiya Hosp, Dept Resp Med, Utsunomiya, Tochigi, Japan

[27] Kameda Med Ctr, Dept Pulmonol, Chiba, Japan

[28] Osaka Red Cross Hosp, Dept Resp Med, Osaka, Japan

[29] Itami City Hosp, Dept Resp Med, Itami, Hyogo, Japan

[30] Teine Keijinkai Hosp, Dept Resp Med, Sapporo, Hokkaido, Japan

来源：

EUROPEAN JOURNAL OF CANCER | 2022年 / 166卷

关键词：

Epidermal growth factor receptor; Histologic transformation; Immune checkpoint inhibitors; Lung cancer; Survival; ADENOCARCINOMA; CHEMOTHERAPY; EPIDEMIOLOGY; CARCINOMAS; INHIBITORS; NIVOLUMAB; MUTATIONS; GEFITINIB; DOCETAXEL;

D O I：

10.1016/j.ejca.2022.02.006

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: This study aimed to determine the incidence and clinical course of epidermal growth factor receptor (EGFR)-mutated lung cancer with histologic transformation (HT). Patients and methods: We conducted a multicentre, retrospective, cohort study of patients with advanced EGFR-mutated lung cancer who received EGFR-tyrosine kinase inhibitors (TKIs) between 2012 and 2019. The primary outcome was the incidence of HT. The secondary outcome was treatment efficacy in patients with HT. Results: In total, 6356 patients were enrolled. In 2624 patients, the histological type was proven by rebiopsy after acquiring resistance to EGFR-TKIs. Among them, 74 patients had HT (incidence rate: 2.8% [95% confidence interval: 2.3%-3.5% ]). The median progression-free survival after EGFR-TKIs and first-line therapy after confirming HT was 10.4 and 4.4 months, respectively, which was not significantly different between patients with transformation to high-grade neuroendocrine carcinoma and those with transformation to another subtype of non-small cell lung cancer. Overall survival after confirming HT was 12.2 months. Twenty-seven patients received immune checkpoint inhibitors: 6 and 21 received immune checkpoint inhibitors before and after confirming HT, respectively. No patients achieved 1-year progression-free survival. The median progression-free survival after immune checkpoint inhibitor therapy after confirming HT was 1.6 months. Conclusion: HT occurred in approximately 3% of EGFR-mutated patients who developed resistance to EGFR-TKIs. Cytotoxic agents are likely to be effective in patients with HT. However, the therapeutic effectiveness of immune checkpoint inhibitors was limited in these patients. Given the rarity of HT and absence of prospective trials, our findings are important to inform the treatment of these patients. (C) 2022 Elsevier Ltd. All rights reserved.

引用

页码：41 / 50

页数：10

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