Prognostic model of long-term advanced stage (IIIB-IV) EGFR mutated non-small cell lung cancer (NSCLC) survivors using real-life data

Abstract

Background There is a lack of useful diagnostic tools to identify EGFR mutated NSCLC patients with long-term survival. This study develops a prognostic model using real world data to assist clinicians to predict survival beyond 24 months. Methods EGFR mutated stage IIIB and IV NSCLC patients diagnosed between January 2009 and December 2017 included in the Spanish Lung Cancer Group (SLCG) thoracic tumor registry. Long-term survival was defined as being alive 24 months after diagnosis. A multivariable prognostic model was carried out using binary logistic regression and internal validation through bootstrapping. A nomogram was developed to facilitate the interpretation and applicability of the model. Results 505 of the 961 EGFR mutated patients identified in the registry were included, with a median survival of 27.73 months. Factors associated with overall survival longer than 24 months were: being a woman (OR 1.78); absence of the exon 20 insertion mutation (OR 2.77); functional status (ECOG 0–1) (OR 4.92); absence of central nervous system metastases (OR 2.22), absence of liver metastases (OR 1.90) or adrenal involvement (OR 2.35) and low number of metastatic sites (OR 1.22). The model had a good internal validation with a calibration slope equal to 0.781 and discrimination (optimism corrected C-index 0.680). Conclusions Survival greater than 24 months can be predicted from six pre-treatment clinicopathological variables. The model has a good discrimination ability. We hypothesized that this model could help the selection of the best treatment sequence in EGFR mutation NSCLC patients.

Prevalence of Epidermal Growth Factor Receptor Exon 20 Insertion Mutations in Non-small-Cell Lung Cancer in Europe: A Pragmatic Literature Review and Meta-analysis

“…One was a large real-world cohort study from France that included 9,435 patients with non-squamous NSCLC [ 42 ]. The other included 505 patients from a Spanish registry [ 43 ]. Both studies reported exon 20 insertion prevalence within the range of values identified by this PLR, at 3.9% and 4.7% of all EGFR mutations, respectively [ 42 , 43 ].…”

“…The other included 505 patients from a Spanish registry [ 43 ]. Both studies reported exon 20 insertion prevalence within the range of values identified by this PLR, at 3.9% and 4.7% of all EGFR mutations, respectively [ 42 , 43 ].…”

Silencing of lncRNA CRNDE attenuates nonsmall‐cell lung cancer progression by mediating the miR‐455‐3p/HDAC2 axis

“…EGFR mutation plays a vital role in the pathogenesis of NSCLC, as it could lead to the metastasis of lung cancer tumors. 36 In this study, we found that CRNDE knockdown could inhibit the proliferation, migration, and invasion of EGFR-mutant NSCLC cells. Takahashi S et al found that CRNDE could promote the progression of EGFR-mutant NSCLC via regulation of eIF4A3/MUC1/ EGFR signaling.…”

Inibidores de checkpoints imunológicos no tratamento de câncer de pulmão de células não pequenas (NSCLC)

“…Carcinoma de pulmão de células não pequenas (NSCLC) O tratamento e diagnóstico precoce podem melhorar o prognóstico, uma vez que a taxa de sobrevivência dos pacientes é de até 5 anos após o diagnóstico do câncer. Entretanto, a taxa de sobrevivência de um paciente com NSCLC dentro desses 5 anos, é de apenas 25% [4], sendo que os pacientes nos estágios IIIB (avançado) e IV (metastático), possuem taxa de sobrevida em torno de 12-24 meses, e um dos fatores que pode diminuir a sobrevida é ser adepto ao tabagismo [14].…”