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Observational Study
. 2024 Nov 2;54(11):1185-1193.
doi: 10.1093/jjco/hyae073.

The effect of epidermal growth factor receptor mutation on adjuvant chemotherapy with tegafur/uracil for patients with completely resected, non-lymph node metastatic non-small cell lung cancer (> 2 cm): a multicenter, retrospective, observational study as exploratory analysis of the CSPOR-LC03 study

Tomohiro Miyoshi  1 , Keiju Aokage  1 , Shun-Ichi Watanabe  2 , Hiroyuki Ito  3 , Noriaki Sakakura  4 , Mingyon Mun  5 , Motohiro Yamashita  6 , Yasuhisa Ohde  7 , Tadashi Aoki  8 , Wataru Nishio  9 , Masataka Taguri  10 , Masahiro Tsuboi  1
Affiliations
Observational Study

The effect of epidermal growth factor receptor mutation on adjuvant chemotherapy with tegafur/uracil for patients with completely resected, non-lymph node metastatic non-small cell lung cancer (> 2 cm): a multicenter, retrospective, observational study as exploratory analysis of the CSPOR-LC03 study

Tomohiro Miyoshi et al. Jpn J Clin Oncol. .

Abstract

Background: The use of adjuvant osimertinib for epidermal growth factor receptor (EGFR) mutants is expected to expand to earlier stage I in the future, potentially competing with the current standard of care, oral tegafur/uracil (UFT), in Japan. However, the effect of EGFR mutation status on the therapeutic effect of UFT remains unclear. This study was conducted as an exploratory analysis of a retrospective observational study that investigated the real-world data of postoperative adjuvant chemotherapy in Japan (CSPOR-LC03).

Methods: Between 2008 and 2013, 1812 patients with completely resected adenocarcinoma diagnosed as pathologic stage I (T1 > 2 cm, TNM classification, sixth edition) who have maintained organ function, and no history of other cancers were included. The primary endpoint was the 5-year disease-free survival (DFS) rate, and we compared this rate between four groups classified based on the administration of adjuvant UFT and EGFR mutation status.

Results: Of the 933 (51%) patients with EGFR mutations, 394 underwent adjuvant UFT therapy. Of the 879 (49%) patients without EGFR mutations, 393 underwent adjuvant UFT therapy. The 5-year DFS of UFT+/EGFR+ and UFT-/EGFR+ patients were 82.0 and 87.1%, respectively, and those of UFT+/EGFR- and UFT-/EGFR- patients were 80.0 and 86.9%, respectively. DFS was significantly worse in the UFT+ group than in the UFT- group (P = 0.015). Adjuvant UFT therapy was not an independent prognostic factor for DFS, regardless of the EGFR mutation status.

Conclusion: In pathologic stage I (>2 cm) lung adenocarcinomas with EGFR mutation, the survival benefit of adjuvant UFT was not observed.

Keywords: adjuvant chemotherapy; epidermal growth factor receptor; lung cancer; tegafur/uracil.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
CONSORT flow diagram. CSPOR, comprehensive support project for oncology research; JCOG, Japan clinical oncology group; GGO, ground-grass opacity; UFT, oral tegafur/uracil combination agent; EGFR, epidermal growth factor receptor.
Figure 2
Figure 2
DFS and OS among all patients. UFT, oral tegafur/uracil combination agent; EGFR, epidermal growth factor receptor; GGO, ground-grass opacity.
Figure 3
Figure 3
DFS among subgroup patients. UFT, oral tegafur/uracil combination agent; EGFR, epidermal growth factor receptor; GGO, ground-grass opacity.
Figure 4
Figure 4
Overall survival among subgroup patients. UFT, oral tegafur/uracil combination agent; EGFR, epidermal growth factor receptor; GGO, ground-grass opacity.
See this image and copyright information in PMC

References

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