Role of surgical treatment in patients with EGFR mutation-positive locally advanced and disseminated non-small-cell lung cancer

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OBJECTIVE

To evaluate the impact of removal of the primary focus on overall and relapse-free survival rates in patients with Stage III—IV non-small cell lung cancer (NSCLC) in the presence of different EGFR mutations during targeted therapy with tyrosine kinase inhibitors.

SUBJECTS AND METHODS

Group 1 consisted of 40 people who received combination (targeted therapy and surgery) treatment, while Group 2 included 44 patients who had targeted therapy only. All the patients were found to have primary lung adenocarcinoma with different EGFR mutations: Del19, L858R, and T790M. Group 1 comprised 5 (12.5%) men and 35 (87.5%) women; their mean age was 58.5 (39 to 80) years. Of these, there were 11 (27.5%) patients with Stage IIIA NSCLC, 6 (15%) with Stage IIIB, 1 (2.5%) with Stage IIIC, and 22 (55%) with Stage IV. Group 2 included 12 (27.3%) men and 32 (72.7%) women; their mean age was 62 (35 to 80) years. Of these, there were 4 (9%) patients with Stage IIIA NSCLC, 9 (20.4%) with Stage IIIB, and 31 (70.5%) with Stage IV.

RESULTS

In Group 1, the median overall survival was 56 (11 to 121) months; the median relapse-free survival was 42 (5 to 63) months. In Group 2, the median overall survival was 30 (2.5 to 52) months; progression was detected in 43 patients; the median relapse-free survival was 12 (1 to 26) months.

CONCLUSION

The findings justify the hypothesis that the primary tumor focus during targeted therapy can be surgically removed to increase overall and relapse-free survival rates in patients with Stage III—IV NSCLC.

Keywords:

lung cancer

EGFR mutation

tyrosine kinase inhibitors

cytoreductive surgery

Authors:

Zaberezhny I.A.

Moscow City Oncology Hospital Sixty-Two Moscow Healthcare Department

Popov M.I.

Moscow City Oncology Hospital No 62

Stroyakovskiy D.L.

Moscow City Oncology Hospital Sixty-Two Moscow Healthcare Department

Kononets P.V.

Moscow City Oncology Hospital No 62

Received:

23.11.2021

Accepted:

24.11.2021

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