Open AccessReal‐world data on EGFR/ALK gene status and first‐line targeted therapy rate in newly diagnosed advanced non‐small cell lung cancer patients in Northern China: A prospective observational study
Author(s) -
Liang Hongge,
Song Xia,
Zhang Yuhui,
Zhang Shucai,
Li Fang,
Fang Jian,
Li Junling,
Liang Li,
Nie Ligong,
Ma Kewei,
Zhang Liangming,
Wang Xiaohong,
Xu Junjun,
Wei Yanxia,
Wang Jinghui,
Song Qi,
Tian Guangming,
Mu Yuxin,
Gu Yangchun,
Yang Lei,
Sun Ping,
Zhong Wei,
Zhao Jing,
Xu Yan,
Chen Minjiang,
Wang Mengzhao
Publication year - 2019
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.13090
Subject(s) - medicine , anaplastic lymphoma kinase , lung cancer , oncology , epidermal growth factor receptor , crizotinib , targeted therapy , performance status , cancer , malignant pleural effusion
Background Tyrosine kinase inhibitors (TKIs) can significantly prolong overall survival for patients with advanced non‐small cell lung cancer (NSCLC) harboring epidermal growth factor receptor ( EGFR )‐mutation or anaplastic lymphoma kinase ( ALK )‐rearrangement. However, the real‐world evaluation status of ALK/EGFR in China remains unclear. Methods We conducted a prospective study including 1134 patients with cytologically or histologically confirmed advanced NSCLC (stage IIIb–IV) at 12 Chinese hospitals. Results The most common evaluation methods were amplification‐refractory mutation system for EGFR status and immunohistochemistry targeting D5F3 for ALK status. Among patients with non‐squamous, the EGFR mutation rate was 44.1% and the ALK rearrangement rate was 10.0%. Among patients with squamous cell carcinoma, the EGFR mutation rate was 8.3% and the ALK rearrangement rate was 3.7%. Among all patients, gender (HR = 1.7, 95%CI = 1.2–2.4, P = 0.006), smoking history (HR = 1.8, 95%CI = 1.3–2.7, P = 0.001), histology (HR = 5.0, 95%CI = 2.4–10.1, P < 0.001), and brain metastases (HR = 1.5, 95%CI = 1.1–2.2, P = 0.017) were independent predictors of EGFR mutation, while age (HR = 2.6, 95%CI = 1.7–4.1, P < 0.001) was an independent predictor of ALK rearrangement. The median time from tumor diagnosis to EGFR or ALK status confirmation was 7 and 5 days, respectively. Targeted therapy rate was 73.8% in EGFR ‐positive patients and 51.4% in ALK ‐positive patients. There was a negative correlation between the first‐line targeted therapy rate and the EGFR mutation detection period (r = −0.152, P = 0.02), while no significant correlation among patients with ALK rearrangement (r = −0.179, P = 0.076). Conclusion Squamous NSCLC patients should also be routinely tested to determine their EGFR / ALK statuses. The first‐line targeted therapy rate remains low in Chinese patients with NSCLC.