Survival past five years with advanced, EGFR-mutated or ALK-rearranged non-small cell lung cancer—is there a “tail plateau” in the survival curve of these patients?

BMC Cancer

Daisuke Hayakawa¹  Takehito Shukuya¹  Naoko Shimada¹  Tetsuhiko Asao¹  Ken Tajima¹  Yoichiro Mitsuishi¹  Rina Shibayama¹  Shiting Xu¹  Shoko Sonobe Shimamura¹  Kazuhisa Takahashi¹  Keita Miura¹  Kana Kurokawa¹  Fumiyuki Takahashi¹ 

[1] Department of Respiratory Medicine, Graduate School of Medicine, Juntendo University;

关键词: EGFR mutation;    ALK rearrangement;    NSCLC;    Long survival;   

DOI  :  10.1186/s12885-022-09421-7

来源: DOAJ

【 摘 要 】

Abstract Background The prognosis of patients with NSCLC harboring oncogenic driver gene alterations, such as EGFR gene mutations or ALK fusion, has improved dramatically with the advent of corresponding molecularly targeted drugs. As patients were followed up for about five years in most clinical trials, the long-term outcomes beyond 5 years are unclear. The objectives of this study are to explore the clinical course beyond five years of chemotherapy initiation and to investigate factors that lead to long-term survival. Methods One hundred and seventy-seven patients with advanced, EGFR-mutated or ALK-rearranged NSCLC who received their first chemotherapy between December 2008 and September 2015 were included. Kaplan Meier curves were drawn for the total cohort and according to subgroups of patients’ characteristics. Results Median OS in the total cohort was 40.6 months, the one-year survival rate was 89%, the three-year survival rate was 54%, and the five-year survival rate was 28%. Median OS was 36.9 months in EGFR-mutated patients and 55.4 months in ALK-rearranged patients. The OS curve seemed to plateau after 72 months, and most of the patients who were still alive after more than five years are on treatment. Female sex, age under 75 years, an ECOG PS of 0 to 1, ALK rearrangement, postoperative recurrence, and presence of brain metastasis were significantly associated with longer OS. Conclusions A tail plateau was found in the survival curves of patients with advanced, EGFR-mutated and ALK-rearranged NSCLC, but most were on treatment, especially with EGFR-mutated NSCLC.

【 授权许可】

Unknown