Clinical Characteristics and Continued Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Administration in EGFR-mutated Non-Small Cell Lung Cancer with Skeletal Metastasis

Clinical Characteristics and Continued Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Administration in EGFR-mutated Non-Small Cell Lung Cancer with Skeletal Metastasis

Cancer Research and Treatment : Official Journal of Korean Cancer Association, January 2016

26790969

Sook-Hee Hong, Yeon-Sil Kim, Ji Eun Lee, In-ho Kim, Seung Joon Kim, Daehee Han, Ie Ryung Yoo, Yang-Guk Chung, Young-Hoon Kim, Kyo-Young Lee, Jin-Hyoung Kang

The aim of this study was to analyze clinical characteristics of skeletal metastasis in epidermal growth factor receptor (EGFR) mutant NSCLC and treatment outcomes of continued EGFR tyrosine kinase inhibitor (TKI) therapy in patients presenting with skeletal metastasis progression. Of the 216 patients treated with EGFR-TKI for management of stage III-IV NSCLC between 2006 and 2012 in Seoul St. Mary's Hospital, 76 patients with confirmed EGFR-mutated NSCLC with skeletal metastases during therapy were analyzed retrospectively. Of 76 patients with EGFR mutant lung cancer with skeletal metastasis, 37 patients developed first PD in skeletal regions. EGFR-TKI was continued in these 37 patients after first progressive disease (PD) in skeletal regions. Median time to first PD of skeletal regions was 8.9 months (95% CI: 4.8-13.0). Median time of continued EGFR-TKI after first PD of skeletal regions was 8.0 months (95% CI: 2.9-13.0) in patients with disease progression of preexisting regions, 5.6 months (95% CI: 4.5-6.7) in patients showing new localized regions, and 3.3 months (95% CI: 1.1-5.5) in patients with multiple new metastatic regions (p=0.006). Median time of post skeletal metastasis progression survival was 23.0 months (95% CI: 13.5-32.5), 15.0 months (95% CI: 3-34.7), and 7.0 months (95% CI: 6.0-8.0) (p=0.004) in the above described patient groups, respectively. Overall, 7 patients (18.9%) had more than one episode of skeletal progression of disease without extraskeletal PD. Continued EGFR-TKI treatment with adequate local treatment after progression of skeletal metastasis may be considered for patients who show disease progression in preexisting regions or local progression.