BackgroundAlthough 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.MethodsAll 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.ResultsBetween 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.ConclusionEGFR 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.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4004-7) contains supplementary material, which is available to authorized users.
8084 Background: Lung cancer is the leading cause of cancer mortality among women in many countries. Gender differences have been reported, most of them based on retrospective analysis. Methods: WORLD07 is a prospective, multicenter, epidemiologic female-specific lung cancer database developed by the Spanish Lung Cancer Group. Data on demographics, previous cancer history, reproductive and hormonal status, diet, alcohol, tobacco, and occupational information are being collected just as histology, stage, treatment and survival. Results: From October 2007 to Nov 2008, 342 female newly diagnosed of lung cancer were collected in an e-database in 20 Spanish centers. Patients (p) characteristics are: median age 61.7 years (y) (range: 36 - 87); Caucasian: 98.2%; Marital status (%): married 67.7, unmarried 11.2, divorced 7.1, widow 14. Educational level (%): basic 57.4, secondary 29.1, university 13.5. Median age of menarche 12.7 y. Children: 79.4% (median: 2); Median age of first child 27 y. Oral contraceptive: 30.6%. Pre-menopausal 15.4%,postmenopausal 84.6%. Median age of menopause 46.7 y. HRT: 5.3%. Median duration of HRT: 4.4 y. Obesity: 11.3%. Smoking habit (%): never (passive smoker/no exposition)/former/current smokers: 42 (42.8/57.2) /19 /39; Median packs/year 72.4. Former smokers: 1–5/5–10/10–15/>15 y (%): 51/11.8/7.8/29.4. Work exposure 3.5%. Alcohol consumption 3.2%. Familial history of cancer: 45.5% (lung cancer 29.7%). Previous history of cancer 13.8% (breast 33.3%). Current lung cancer histology (%): adenocarcinoma/BAC/squamous/large cell/NOS: 70.4/5.7/10.4/7.9/5.7. SCLC 11.8%. TNM I/II/III/IV (%): 16/3.9/28.7/51.4. Surgical treatment 24.7 % (lobectomy/pneumonectomy/exploratory: 85.5/9.2/5.3%). Available data of 122 stage IV NSCLC p: 74.6% receive chemotherapy, 92.3% of them two drugs and 68.9 % platinum-based (59% cisplatin). EGFR mutations analysis 7.9%. Conclusions: According this series, 42% of Spanish lung cancer women are never smokers and 70.4% have adenocarcinoma. Other collected information, choice of treatment and survival outcomes will be also analyzed. No significant financial relationships to disclose.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.