Correlation between status of epidermal growth factor receptor mutation and distant metastases of lung adenocarcinoma upon initial diagnosis based on 1063 patients in China

Abstract

The study aimed to explore the correlations between status of epidermal growth factor receptor (EGFR) mutations and distant metastases. A total of 1063 patients with lung adenocarcinoma indentified with status of EGFR mutations from August 2010 to May 2015 at Shanxi Cancer Hospital were enrolled. 456 patients were confirmed with EGFR mutations. The associations among EGFR mutations, clinical factors, and distant metastases at initial diagnosis were evaluated. Patients harboring EGFR mutation were more likely to be female (P < 0.001), with no smoking history (P < 0.001), brain metastases (P = 0.029), and higher ECOG performance scores (P = 0.025). The correlation between EGFR mutation status and distant metastases showed statistical significance both in univariate (P = 0.022) and in multivariate analysis (OR 1.573, 95 % CI 1.202-2.059, P = 0.001) especially in brain metastases (OR 1.675, 95 % CI 1.132-2.479, P = 0.010) and lung metastases (OR 1.571, 59 % CI 1.101-2.243 P = 0.013). Furthermore, the 19del mutations showed associations with brain metastases (OR 1.586, 95 % CI 1.028-2.447, P = 0.037), and lung metastases (OR 1.587, 95 % CI 1.065-2.346, P = 0.023). The exon 21 point mutations showed statistically significant differences in liver metastases (OR 1.987, 95 % CI 1.094-3.067, P = 0.024). In conclusion, the EGFR mutations in lung adenocarcinoma patients were independently correlated with distant metastases. Subgroup analyses showed that patients harboring 19del mutations presented different distant metastases compared with those harboring 21 point mutaions.

EGFR-TKI plus brain radiotherapy versus EGFR-TKI alone in the management of EGFR-mutated NSCLC patients with brain metastases

“…The possible reasons were as follows. Firstly, from the aspect of clinical characteristics between mutation subtypes, a retrospective study on 1,063 patients has demonstrated that exon 19 deletion rather than exon 21 mutation was associated with high incidence of developing BM during the course of therapy (38), which complied with the results founded in Li et al in 2015 (39). Another study further demonstrated that BM lesions with L858R mutation were located significantly closer to the brain surface (including preferential involvement of the caudate, cerebellum, and temporal lobe) than lesions with exon 19 deleted or wildtype EGFR (40).…”

Correlation between EGFR mutation status and the incidence of brain metastases in patients with non-small cell lung cancer

“…The NOS was used to perform quality assessment on all 22 studies and 14 (17,18,(25)(26)(27)(28)30,(32)(33)(34)(35)(36)38,42) high-quality and 8 (16,19,29,31,37,(39)(40)(41) as low-quality.…”

Association of molecular status and metastatic organs at diagnosis in patients with stage IV non-squamous non-small cell lung cancer

“…Several studies have suggested that the cumulative incidence of brain as well as bone metastases may be higher in patients with EGFR+ NSCLC as compared to EGFR-wt [5][6][7]. Studies (N = 189-1063) evaluating bone and brain metastases at initial stage IV diagnosis have reported conflicting results [8][9][10][11].…”