Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain

Background: Although the benefit of first-line epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) over chemotherapy has been demonstrated in several clinical trials, data from clinical practice is lacking and the optimal EGFR TKI to be used remains unclear. This study aims to...

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Autores: Arriola, E, Gomez, RG, Diz, P, Majem, M, Aguillo, MM, Valdivia, J, Paredes, A, Sanchez-Torres, JM, Munoz, SP, Barneto, I, Gutierrez, V, Santiago, JMA, Aparisi, F, Isla, D, Ponce, S, Baz, DV, Artal, A, Amador, M, Provencio, M
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Recursos:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p3971
Acesso em linha:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3971
Access Level:acceso abierto
Palavra-chave:Clinical management
Chemotherapy
Epidermal growth factor receptor (EGFR) gene mutation
EGFR tyrosine kinase inhibitors (TKIs)
Non-small-cell lung cancer (NSCLC)
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spelling Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in SpainArriola, EGomez, RGDiz, PMajem, MAguillo, MMValdivia, JParedes, ASanchez-Torres, JMMunoz, SPBarneto, IGutierrez, VSantiago, JMAAparisi, FIsla, DPonce, SBaz, DVArtal, AAmador, MProvencio, MClinical managementChemotherapyEpidermal growth factor receptor (EGFR) gene mutationEGFR tyrosine kinase inhibitors (TKIs)Non-small-cell lung cancer (NSCLC)Background: Although the benefit of first-line epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) over chemotherapy has been demonstrated in several clinical trials, data from clinical practice is lacking and the optimal EGFR TKI to be used remains unclear. This study aims to assess the real-life diagnostic and clinical management and outcome of patients with advanced non-small-cell lung cancer (NSCLC) carrying EGFR mutations in Spain. Methods: All consecutive patients recently diagnosed with advanced or metastatic NSCLC from April 2010 to December 2011 in 18 Spanish hospitals and carrying EGFR mutations were retrospectively evaluated. Results: Between March and November 2013, a total of 187 patients were enrolled (98.3% Caucasian, 61.9% female, 54.9% never-smokers, 89.0% adenocarcinoma). Mutation testing was mainly performed on biopsy tumour tissue specimens (69.0%) using a qPCR-based test (90%) (47.0% Therascreen EGFR PCR Kit). Common sensitising mutations were detected in 79.8% of patients: 57.1% had exon 19 deletions and 22.6% exon 21 L858R point mutations. The vast majority of patients received first-line therapy (n = 168; 92.8%). EGFR TKIs were the most commonly used first-line treatment (81.5%), while chemotherapy was more frequently administered as a second-and third-line option (51.9% and 56.0%, respectively). Of 141 patients who experienced disease progression, 79 (56.0%) received second-line treatment. After disease progression on first-line TKIs (n = 112), 33.9% received chemotherapy, 8.9% chemotherapy and a TKI, and 9.8% continued TKI therapy. Most patients received first-line gefitinib (83.0%), while erlotinib was more frequently used in the second-line setting (83.0%). Progression-free survival (PFS) and overall survival (OS) in patients harbouring common mutations were 11.1 months and 20.1 months respectively (exon 19 deletions: 12.4 and 21.4 months; L858R: 8.3 and 14.5 months), and 3.9 months and 11.1 months respectively for those with rare mutations. Conclusion: EGFR TKIs (gefitinib and erlotinib) are used as the preferred first-line treatment while chemotherapy is more frequently administered as a second-and third-line option in routine clinical practice in Spain. In addition, efficacy data obtained in the real-life setting seem to concur with data from EGFR TKI phase III pivotal studies in NSCLC.BMC2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3971BMC CANCERISSN: 14712407reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p39712026-06-14T12:41:47Z
dc.title.none.fl_str_mv Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
title Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
spellingShingle Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
Arriola, E
Clinical management
Chemotherapy
Epidermal growth factor receptor (EGFR) gene mutation
EGFR tyrosine kinase inhibitors (TKIs)
Non-small-cell lung cancer (NSCLC)
title_short Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
title_full Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
title_fullStr Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
title_full_unstemmed Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
title_sort Clinical management and outcome of patients with advanced NSCLC carrying EGFR mutations in Spain
dc.creator.none.fl_str_mv Arriola, E
Gomez, RG
Diz, P
Majem, M
Aguillo, MM
Valdivia, J
Paredes, A
Sanchez-Torres, JM
Munoz, SP
Barneto, I
Gutierrez, V
Santiago, JMA
Aparisi, F
Isla, D
Ponce, S
Baz, DV
Artal, A
Amador, M
Provencio, M
author Arriola, E
author_facet Arriola, E
Gomez, RG
Diz, P
Majem, M
Aguillo, MM
Valdivia, J
Paredes, A
Sanchez-Torres, JM
Munoz, SP
Barneto, I
Gutierrez, V
Santiago, JMA
Aparisi, F
Isla, D
Ponce, S
Baz, DV
Artal, A
Amador, M
Provencio, M
author_role author
author2 Gomez, RG
Diz, P
Majem, M
Aguillo, MM
Valdivia, J
Paredes, A
Sanchez-Torres, JM
Munoz, SP
Barneto, I
Gutierrez, V
Santiago, JMA
Aparisi, F
Isla, D
Ponce, S
Baz, DV
Artal, A
Amador, M
Provencio, M
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Clinical management
Chemotherapy
Epidermal growth factor receptor (EGFR) gene mutation
EGFR tyrosine kinase inhibitors (TKIs)
Non-small-cell lung cancer (NSCLC)
topic Clinical management
Chemotherapy
Epidermal growth factor receptor (EGFR) gene mutation
EGFR tyrosine kinase inhibitors (TKIs)
Non-small-cell lung cancer (NSCLC)
description Background: Although the benefit of first-line epidermal growth factor receptor (EGFR) tyrosine-kinase inhibitors (TKIs) over chemotherapy has been demonstrated in several clinical trials, data from clinical practice is lacking and the optimal EGFR TKI to be used remains unclear. This study aims to assess the real-life diagnostic and clinical management and outcome of patients with advanced non-small-cell lung cancer (NSCLC) carrying EGFR mutations in Spain. Methods: All consecutive patients recently diagnosed with advanced or metastatic NSCLC from April 2010 to December 2011 in 18 Spanish hospitals and carrying EGFR mutations were retrospectively evaluated. Results: Between March and November 2013, a total of 187 patients were enrolled (98.3% Caucasian, 61.9% female, 54.9% never-smokers, 89.0% adenocarcinoma). Mutation testing was mainly performed on biopsy tumour tissue specimens (69.0%) using a qPCR-based test (90%) (47.0% Therascreen EGFR PCR Kit). Common sensitising mutations were detected in 79.8% of patients: 57.1% had exon 19 deletions and 22.6% exon 21 L858R point mutations. The vast majority of patients received first-line therapy (n = 168; 92.8%). EGFR TKIs were the most commonly used first-line treatment (81.5%), while chemotherapy was more frequently administered as a second-and third-line option (51.9% and 56.0%, respectively). Of 141 patients who experienced disease progression, 79 (56.0%) received second-line treatment. After disease progression on first-line TKIs (n = 112), 33.9% received chemotherapy, 8.9% chemotherapy and a TKI, and 9.8% continued TKI therapy. Most patients received first-line gefitinib (83.0%), while erlotinib was more frequently used in the second-line setting (83.0%). Progression-free survival (PFS) and overall survival (OS) in patients harbouring common mutations were 11.1 months and 20.1 months respectively (exon 19 deletions: 12.4 and 21.4 months; L858R: 8.3 and 14.5 months), and 3.9 months and 11.1 months respectively for those with rare mutations. Conclusion: EGFR TKIs (gefitinib and erlotinib) are used as the preferred first-line treatment while chemotherapy is more frequently administered as a second-and third-line option in routine clinical practice in Spain. In addition, efficacy data obtained in the real-life setting seem to concur with data from EGFR TKI phase III pivotal studies in NSCLC.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3971
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=3971
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv BMC CANCER
ISSN: 14712407
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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repository.mail.fl_str_mv
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