Diffuse Lung Metastases in EGFR-Mutant Non-Small Cell Lung Cancer

Digumarthy, Subba R.; Mendoza, Dexter P.; Padole, Atul; Chen, Tianqi; Peterson, Paul; Piotrowska, Zofia; Sequist, Lecia V.

doi:10.3390/cancers11091360

Cited by 20 publications

(32 citation statements)

References 39 publications

(51 reference statements)

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“…This, however, is in contrast to EGFR-mutated NSCLC, reported to have increased incidence of subsolid and pure ground-glass lesions and increased frequency air bronchogram in the tumor [41]. For instance, our group has previously reported the presence of air bronchograms in up to 28% of EGFR-mutated NSCLC tumors [46], in contrast to their presence in less than 4% of METex14-mutated tumors in our current cohort.…”

Section: Discussioncontrasting

confidence: 88%

“…This pattern of metastasis is in contrast to that of EGFR-mutated and ALK-rearranged NSCLC, which have been associated with an increased propensity for intrathoracic metastases. For example, in our group's previous work, we reported a frequency of 69% for lung metastases in patients with EGFR-mutated NSCLC, which tended to be diffuse and miliary-like when present [46]. In comparison, the frequency of lung metastases in our cohort of patients with METex14-mutated NSCLC was less than 15%.…”

Section: Discussioncontrasting

confidence: 51%

“…In our cohort, the average age of 71.4 years was higher than those previously reported for other targetable driver mutations [46,48,49]. This advanced age was reported in another study, which found a similar median age of 72.5 years [26].…”

Section: Discussionsupporting

confidence: 51%

“…In our cohort, 20% of patients with metastatic disease had brain metastases at the time of initial diagnosis. In our group's previous works, we reported frequencies of brain metastases of 40% in patients with EGFR mutations [46], 24% in those with ALK rearrangements [45], 10% in those with BRAF mutations [44], and 9% in those with ROS1 rearrangements [48]. The high incidence of brain metastases in these mutational subgroups highlights the need for agents that can reliably penetrate the blood-brain barrier.…”

Section: Discussionmentioning

confidence: 77%

“…Several studies have investigated the imaging features that may predict the presence of EGFR, ALK, ROS1, and other potentially targetable mutations in NSCLC [39][40][41][42][43][44][45][46][47][48]. To our knowledge, however, no study has systematically assessed the radiologic features of NSCLC harboring primary METex14 skipping (METex14-mutated NSCLC).…”

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic and Imaging Features of Non-Small-Cell Lung Cancer with MET Exon 14 Skipping Mutations

Digumarthy

Mendoza

Zhang

et al. 2019

Cancers

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MET exon 14 (METex14) skipping mutations are an emerging potentially targetable oncogenic driver mutation in non-small-cell lung cancer (NSCLC). The imaging features and patterns of metastasis of NSCLC with primary METex14 skipping mutations (METex14-mutated NSCLC) are not well described. Our goal was to determine the clinicopathologic and imaging features that may suggest the presence of METex14 skipping mutations in NSCLC. This IRB-approved retrospective study included NSCLC patients with primary METex14 skipping mutations and pre-treatment imaging data between January 2013 and December 2018. The clinicopathologic characteristics were extracted from electronic medical records. The imaging features of the primary tumor and metastases were analyzed by two thoracic radiologists. In total, 84 patients with METex14-mutated NSCLC (mean age = 71.4 ± 10 years; F = 52, 61.9%, M = 32, 38.1%; smokers = 47, 56.0%, nonsmokers = 37, 44.0%) were included in the study. Most tumors were adenocarcinoma (72; 85.7%) and presented as masses (53/84; 63.1%) that were peripheral in location (62/84; 73.8%). More than one in five cancers were multifocal (19/84; 22.6%). Most patients with metastatic disease had only extrathoracic metastases (23/34; 67.6%). Fewer patients had both extrathoracic and intrathoracic metastases (10/34; 29.4%), and one patient had only intrathoracic metastases (1/34, 2.9%). The most common metastatic sites were the bones (14/34; 41.2%), the brain (7/34; 20.6%), and the adrenal glands (7/34; 20.6%). Four of the 34 patients (11.8%) had metastases only at a single site. METex14-mutated NSCLC has distinct clinicopathologic and radiologic features.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussioncontrasting

confidence: 51%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

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Clinicopathologic and Imaging Features of Non-Small-Cell Lung Cancer with MET Exon 14 Skipping Mutations

Digumarthy

Mendoza

Zhang

et al. 2019

Cancers

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Lung Cancer in Women

Tsai

Chu

Blessing

et al. 2022

The Annals of Thoracic Surgery

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Clinical and Imaging Features of Non–Small-Cell Lung Cancer in Young Patients

Garrana

Dagogo‐Jack

Cobb

et al. 2021

Clinical Lung Cancer

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Nonesmall-cell lung cancer (NSCLC) in young patients is rare. We retrospectively analyzed the presenting symptoms, clinicopathologic characteristics, and imaging features of 166 young patients with NSCLC. We found that young patients with NSCLC often present with nonspecific symptoms and have advanced disease at diagnosis, which can mimic other pathologies. Targetable genomic alterations are common and may drive imaging features. Background: Nonesmall-cell lung cancer (NSCLC) in young adult patients is rare, with scarce data available in patients aged < 40 years and even less in those aged < 35 years. Our goal was to determine the presenting symptoms, clinicopathologic characteristics, and imaging features of young patients with NSCLC at time of diagnosis and compare them to those of older adults. Patients and Methods: We retrospectively analyzed the medical records and imaging of young patients ( 40 years old) with NSCLC treated at our institution between 1998 and 2018. Patients < 35 years old were compared to those between 35 and 40 years old. Characteristics of patients 40 years old were compared to older patients (> 40 years) from publicly available data sets. Results: We identified 166 young patients with NSCLC (median age, 36.6 years; range, 18-40 years). Most presented with nonspecific respiratory symptoms and were diagnosed with pneumonia (84/136, 62%). Compared to patients < 35 years old, patients 35-40 years old were more likely to have malignancy detected incidentally (15% vs. 5%, P ¼ .04). Patients < 35 years old were more likely to have central tumors (55% vs. 33%, P ¼ .02) and to have bone (38% vs. 19%, P ¼ .007) and lung (39% vs. 24%, P ¼ .03) metastases. Compared to older patients (> 40 years), young patients were more likely to be never smokers (65.0% vs. 14.7%, P < .001) and to have advanced disease (88% vs. 66%, P < .001). Conclusion: Young patients with NSCLC often present with nonspecific symptoms and have advanced disease at diagnosis, often mimicking other pathologies. Awareness of the clinical presentation and imaging features of NSCLC in young patients may help minimize delays in diagnoses.

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Diffuse Lung Metastases in EGFR-Mutant Non-Small Cell Lung Cancer

Cited by 20 publications

References 39 publications

Clinicopathologic and Imaging Features of Non-Small-Cell Lung Cancer with MET Exon 14 Skipping Mutations

Clinicopathologic and Imaging Features of Non-Small-Cell Lung Cancer with MET Exon 14 Skipping Mutations

Lung Cancer in Women

Clinical and Imaging Features of Non–Small-Cell Lung Cancer in Young Patients

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