Post-Progression Survival Is Strongly Associated with Overall Survival in Patients Exhibiting Postoperative Relapse of Non-Small-Cell Lung Cancer Harboring Sensitizing EGFR Mutations.

Hisao Imai,Kyoichi Kaira,Ryoichi Onozato,Daijiro Kobayashi,Maiko Ginnan,Koichi Minato

doi:10.3390/medicina57050508

Hisao Imai, Kyoichi Kaira + Show 4 more

Open Access

https://doi.org/10.3390/medicina57050508

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Abstract

Background and Objective: Patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitizing epidermal growth factor receptor (EGFR) mutations show a good response to EGFR-tyrosine kinase inhibitors (EGFR-TKIs). The subsequent treatments influence the evaluability of the efficacy of front-line therapy on overall survival (OS). Consequently, we evaluated the associations of relapse-free survival (RFS) and post-progression survival (PPS) with OS in patients who exhibited postoperative relapse of EGFR-mutated NSCLC. Materials and Methods: We analyzed the data of 35 patients with EGFR-mutated NSCLC who underwent complete resection between January 2007 and June 2019. The correlations of RFS and PPS with OS were evaluated at the individual patient level. Results: Linear regression and Spearman’s rank correlation analyses demonstrated that the PPS highly correlated with OS (r = 0.91, p < 0.05, R2 = 0.85), whereas the RFS weakly associated with OS (r = 0.36, p < 0.05, R2 = 0.25). Age and performance status at relapse were significantly associated with PPS. Conclusion: Overall, PPS was more strongly and significantly associated with OS than RFS. These results suggest that the OS of our cohort may be affected by treatments, besides postoperative relapse. However, larger-scale prospective studies are needed to confirm these results.

Highlights

Lung cancer is a major reason for cancer-related mortality globally, and non-small-cell lung cancer (NSCLC) accounts for approximately 80% of all lung cancers [1]
We evaluated the correlations of overall survival (OS) with relapse-free survival (RFS) and post-progression survival (PPS) at the individual patient level in patients who exhibited postoperative relapse of NSCLC harboring sensitizing epidermal growth factor receptor (EGFR) mutations
Age at relapse and performance status (PS) at relapse were significantly associated with PPS

Summary

Introduction

Lung cancer is a major reason for cancer-related mortality globally, and non-small-cell lung cancer (NSCLC) accounts for approximately 80% of all lung cancers [1]. A phase III trial demonstrated that prolonged progression-free survival (PFS) does not always result in prolonged OS of patients with NSCLC [6]. Post-progression survival (PPS), which is calculated as the difference between OS and PFS, is reportedly highly correlated with OS following first-line therapy with molecular targeted agents, such as EGFR-tyrosine kinase inhibitors (TKIs) [7,8,9]. The subsequent treatments influence the evaluability of the efficacy of front-line therapy on overall survival (OS). We evaluated the associations of relapse-free survival (RFS) and post-progression survival (PPS) with OS in patients who exhibited postoperative relapse of EGFR-mutated NSCLC. Conclusion: Overall, PPS was more strongly and significantly associated with OS than RFS These results suggest that the OS of our cohort may be affected by treatments, besides postoperative relapse. Larger-scale prospective studies are needed to confirm these results

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Conclusion