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Review
. 2021 Jun 23;13(13):3144.
doi: 10.3390/cancers13133144.

Reporting of Incidence and Outcome of Bone Metastases in Clinical Trials Enrolling Patients with Epidermal Growth Factor Receptor Mutated Lung Adenocarcinoma-A Systematic Review

Anita Brouns  1   2 , Safiye Dursun  2 , Gerben Bootsma  1 , Anne-Marie C Dingemans  2   3 , Lizza Hendriks  2
Affiliations
Review

Reporting of Incidence and Outcome of Bone Metastases in Clinical Trials Enrolling Patients with Epidermal Growth Factor Receptor Mutated Lung Adenocarcinoma-A Systematic Review

Anita Brouns et al. Cancers (Basel). .

Abstract

Bone metastases, occurring in 30-60% of patients with non-small cell lung cancer (NSCLC), are associated with decreased survival, cancer-induced bone pain, and skeletal-related events (SREs). Those with an activating epidermal growth factor mutation (EGFR+) seem to be more prone to develop bone metastases. To gain more insight into bone metastases-related outcomes in EGFR+ NSCLC, we performed a systematic review on Pubmed (2006-2021). Main inclusion criteria: prospective, phase II/III trials evaluating EGFR-tyrosine kinase inhibitors, ≥10 EGFR+ patients included, data on bone metastases and/or bone-related outcomes available. Out of 663 articles, 21 (3176 EGFR+ patients) met the eligibility criteria; 4 phase III (one double blind), 17 phase II trials (three randomized) were included. In seven trials dedicated bone imaging was performed at baseline. Mean incidence of bone metastases at diagnosis was 42%; 3-33% had progression in the bone upon progression. Except for one trial, it was not specified whether the use of bone target agents was permitted, and in none of the trials, occurrence of SREs was reported. Despite the high incidence of bone metastases in EGFR+ adenocarcinoma, there is a lack of screening for, and reporting on bone metastases in clinical trials, as well as permitted bone-targeted agents and SREs.

Keywords: bone metastases; epidermal growth factor mutation; epidermal growth factor receptor mutation; lung adenocarcinoma; non-small cell lung cancer; skeletal-related events; tyrosine kinase inhibitor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

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Figure 1
Flowchart.
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References

    1. Kerner G.S.M.A., Schuuring E., Sietsma J., Hiltermann T.J.N., Pieterman R.M., De Leede G.P.J., Van Putten J.W.G., Liesker J., Renkema T.E.J., Van Hengel P., et al. Common and Rare EGFR and KRAS Mutations in a Dutch Non-Small-Cell Lung Cancer Population and Their Clinical Outcome. PLoS ONE. 2013;8:e70346. doi: 10.1371/journal.pone.0070346. - DOI - PMC - PubMed
    1. Rosell R., Moran T., Queralt C., Porta R., Cardenal F., Camps C., Majem M., Lopez-Vivanco G., Isla D., Provencio M., et al. Screening for Epidermal Growth Factor Receptor Mutations in Lung Cancer. N. Engl. J. Med. 2009;361:958–967. doi: 10.1056/NEJMoa0904554. - DOI - PubMed
    1. Sequist L.V., Heist R.S., Shaw A.T., Fidias P., Rosovsky R., Temel J.S., Lennes I.T., Digumarthy S., Waltman B.A., Bast E., et al. Implementing multiplexed genotyping of non-small-cell lung cancers into routine clinical practice. Ann. Oncol. 2011;22:2616–2624. doi: 10.1093/annonc/mdr489. - DOI - PMC - PubMed
    1. Yamamoto N., Seto T., Nishio M., Goto K., Okamoto I., Yamanaka T., Tanaka M., Takahashi K., Fukuoka M., Yamamoto N. Erlotinib plus bevacizumab (EB) versus erlotinib alone (E) as first-line treatment for advanced EGFR mutation–positive non-squamous non–small-cell lung cancer (NSCLC): Survival follow-up results of JO25567. J. Clin. Oncol. 2018;36:9007. doi: 10.1200/JCO.2018.36.15_suppl.9007. - DOI - PubMed
    1. Maemondo M., Fukuhara T., Saito H., Furuya N., Watanabe K., Sugawara S., Iwasawa S., Tsunezuka Y., Yamaguchi O., Okada M., et al. NEJ026: Final overall survival analysis of bevacizumab plus erlotinib treatment for NSCLC patients harboring activating EGFR-mutations. J. Clin. Oncol. 2020;38:9506. doi: 10.1200/JCO.2020.38.15_suppl.9506. - DOI