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. 2022 Apr:165:195-204.
doi: 10.1016/j.ejca.2022.01.038. Epub 2022 Mar 3.

A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands

Deirdre M H J Ten Berge  1 , Mieke J Aarts  2 , Harry J M Groen  3 , Joachim G J V Aerts  4 , Jeroen S Kloover  5
Affiliations
Free article

A population-based study describing characteristics, survival and the effect of TKI treatment on patients with EGFR mutated stage IV NSCLC in the Netherlands

Deirdre M H J Ten Berge et al. Eur J Cancer. 2022 Apr.
Free article

Abstract

Introduction: Since 2011, treatment guidelines advise targeted therapy (tyrosine kinase inhibitor, TKI) for patients with activating epidermal growth factor receptor (EGFR) mutations (EGFR+) in non-small cell lung cancer (NSCLC). We describe characteristics, first line treatment and survival of patients diagnosed with EGFR+ NSCLC in a European population, focussing on age, gender and trends over time and compare to the whole group and EGFR-.

Methods: All patients with non-squamous NSCLC stage IV, diagnosed 2011-2018, were identified from the population-based Netherlands Cancer Registry (N = 31,291).

Results: Among all, 7.0% were registered to be EGFR+, with highest prevalence in females <40 years (16%). Median overall survival (OS) ranged from 3.5 months in the EGFR- group >65 years to 23.6 months in the EGFR+ group <50 years treated with TKI. Over time, OS for the whole group increased by 0.6 months, of which 33% due to TKI treatment in EGFR+. The increase was strongest in females <50 years, where median OS almost doubled to 12.4 months. In the EGFR+, multivariable hazard of death was most strongly associated with the use of TKI (HR 0.45(0.41-0.49)). Of the patients with EGFR+ this space need or not, 71% received TKI treatment. Being young reduced the hazard of death (HR 0.71(95%CI:0.59-0.85)) irrespective of treatment, while male gender increased the hazard of death (HR 1.22(95%CI:1.11-1.33)).

Conclusion: At population level, TKI treatment in patients with non-squamous NSCLC stage IV EGFR+ has very strong beneficial effects on outcome. Of the improvement in OS that was made over the years for the whole group, about one third seems to be attributed to TKI treatment in EGFR+ patients.

Keywords: EGFR; Non-small cell lung cancer; TKI; Targeted therapy; Young patients.

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Conflict of interest statement

Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MJ Aarts reports grants from Amgen, outside the submitted work. HJM Groen reports other from Novartis, other from Eli Lilly, other from Merck, BMS, grants and other from Boehriger-Ingelheim, grants from Novartis, other from Roche, during the conduct of the study. JGJV Aerts reports personal fees and non-financial support from Msd, personal fees from Bms, personal fees from Boehringer-Ingelheim, personal fees from Amphera, personal fees from Eli-lilly, personal fees from Takeda, personal fees from Bayer, personal fees from Roche, personal fees from Astra zeneca, outside the submitted work; In addition, Dr. Aerts has a patent allogenic tumor cell lysate licensed to Amphera, a patent combination immunotherapy in cancer pending, and a patent biomarker for immunotherapy pending. The other authors have declared no conflicts of interest.