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The Impact of EGFR Tyrosine Kinase Inhibitor on the Natural Course of Concurrent Subsolid Nodules in Patients with Non–Small Cell Lung Cancer

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Purpose: The role of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the management of persistent subsolid nodules (SSNs) is unclear. This study aimed to investigate the impact of EGFR-TKIs on concurrent SSNs in patients with stage IV non-small cell lung cancer (NSCLC). Materials and methods: Patients who received an EGFR-TKI for at least 1 month for stage IV NSCLC and had concurrent SSN(s) that had existed for at least 3 months on chest computed tomography were included in this retrospective study. Size change of each nodule before and after EGFR-TKI therapies were evaluated using a cutoff value of 2 mm; increase (≥ 2 mm), decrease (≤ -2 mm), and no change (-2 mm < size change < +2 mm). Results: A total of 77 SSNs, 51 pure ground-glass (66.2%) and 26 part-solid nodules (33.8%), were identified in 59 patients who received gefitinib (n=45) and erlotinib (n=14). Among 58 EGFR mutation analysis performed for primary lung cancer, 45 (77.6%) were EGFR mutant. The proportions of decrease group were 19.5% (15/77) on per-nodule basis and 25.4% (15/59) on per-patient basis. Four SSNs (5.2%) disappeared completely. On per-patient based multivariable analysis, EGFR exon 19 deletion positivity for primary lung cancer was associated with a decrease after initial EGFR-TKI therapy (adjusted odds ratio, 4.29; 95% confidence interval, 1.21 to 15.29; p=0.025). Conclusion: Approximately 20% of the concurrent SSNs decreased after the initial EGFR-TKI therapy. EGFR exon 19 deletion positivity for primary lung cancer was significantly associated with the size change of concurrent SSNs.

Abstract

Purpose: The role of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in the management of persistent subsolid nodules (SSNs) is unclear. This study aimed to investigate the impact of EGFR-TKIs on concurrent SSNs in patients with stage IV non-small cell lung cancer (NSCLC). Materials and methods: Patients who received an EGFR-TKI for at least 1 month for stage IV NSCLC and had concurrent SSN(s) that had existed for at least 3 months on chest computed tomography were included in this retrospective study. Size change of each nodule before and after EGFR-TKI therapies were evaluated using a cutoff value of 2 mm; increase (≥ 2 mm), decrease (≤ -2 mm), and no change (-2 mm < size change < +2 mm). Results: A total of 77 SSNs, 51 pure ground-glass (66.2%) and 26 part-solid nodules (33.8%), were identified in 59 patients who received gefitinib (n=45) and erlotinib (n=14). Among 58 EGFR mutation analysis performed for primary lung cancer, 45 (77.6%) were EGFR mutant. The proportions of decrease group were 19.5% (15/77) on per-nodule basis and 25.4% (15/59) on per-patient basis. Four SSNs (5.2%) disappeared completely. On per-patient based multivariable analysis, EGFR exon 19 deletion positivity for primary lung cancer was associated with a decrease after initial EGFR-TKI therapy (adjusted odds ratio, 4.29; 95% confidence interval, 1.21 to 15.29; p=0.025). Conclusion: Approximately 20% of the concurrent SSNs decreased after the initial EGFR-TKI therapy. EGFR exon 19 deletion positivity for primary lung cancer was significantly associated with the size change of concurrent SSNs.

참고문헌 (30)

  1. National Lung Screening Trial Research Team, "Lung cancer incidence and mortality with extended follow-up in the national lung screening trial", J Thorac Oncol, 14, pp.1732~1742 (2019)
  2. van Iersel CA, "Risk-based selection from the general population in a screening trial : selection criteria, recruitment and power for the Dutch-Belgian randomised lung cancer multi-slice CT screening trial(NELSON)", Int J Cancer, 120, pp.868~874 (2007)
  3. Naidich DP, "Recommendations for the management of subsolid pulmonary nodules detected at CT : a statement from the Fleischner Society", Radiology, 266, pp.304~317 (2013)
  4. Callister ME, "British Thoracic Society guidelines for the investigation and management of pulmonary nodules", Thorax, 70(Suppl 2), pp.ii1~ii54 (2015)
  5. Chang B, "Natural history of pure ground-glass opacity lung nodules detected by low-dose CT scan", Chest, 143, pp.172~178 (2013)
  6. Kodama K, "Natural history of pure ground-glass opacity after long-term follow-up of more than 2 years", Ann Thorac Surg, 73, pp.386~392 (2002)
  7. Gardiner N, "The revised lung adenocarcinoma classification-an imaging guide", J Thorac Dis, 6(Suppl 5), pp.S537~S546 (2014)
  8. Sawada S, "Evaluation of lesions corresponding to ground-glass opacities that were resected after computed tomography follow-up examination", Lung Cancer, 65, pp.176~179 (2009)
  9. Yoshida J, "Limited resection trial for pulmonary ground-glass opacity nodules : fifty-case experience", J Thorac Cardiovasc Surg, 129, pp.991~996 (2005)
  10. Kobayashi Y, "How long should small lung lesions of ground-glass opacity be followed?", J Thorac Oncol, 8, pp.309~314 (2013)
  11. Lee H, "Genomic alterations of ground-glass nodular lung adenocarcinoma", Sci Rep, 8, pp.7691~ (2018)
  12. Yano M, "Epidermal growth factor receptor gene mutation and computed tomographic findings in peripheral pulmonary adenocarcinoma", J Thorac Oncol, 1, pp.413~416 (2006)
  13. Lu Q, "Epidermal growth factor receptor mutation accelerates radiographic progression in lung adenocarcinoma presented as a solitary ground-glass opacity", J Thorac Dis, 10, pp.6030~6039 (2018)
  14. Cho JH, "Impact of EGFR mutation on the clinical efficacy of PD-1 inhi-bitors in patients with pulmonary adenocarcinoma", J Cancer Res Clin Oncol, 145, pp.1341~1349 (2019)
  15. Bak SH, "Quantitative CT scanning analysis of pure ground-glass opacity nodules predicts further CT scanning change", Chest, 149, pp.180~191 (2016)
  16. Hiramatsu M, "Pulmonary ground-glass opacity(GGO)lesions-large size and a history of lung cancer are risk factors for growth", J Thorac Oncol, 3, pp.1245~1250 (2008)
  17. Kobayashi Y, "Genetic features of pulmonary adenocarcinoma presenting with ground-glass nodules : the differences between nodules with and without growth", Ann Oncol, 26, pp.156~161 (2015)
  18. Seidelman JL, "Incidental, subsolid pulmonary nodules at CT : etiology and management", Cancer Imaging, 13, pp.365~373 (2013)
  19. Lee CT, "Multifocal ground-glass opacities : multifocal origin versus intrapulmonary metastasis", J Thorac Dis, 10, pp.1253~1255 (2018)
  20. Chung JH, "Epidermal growth factor receptor mutation and pathologic-radiologic correlation between multiple lung nodules with ground-glass opacity differentiates multicentric origin from intrapulmonary spread", J Thorac Oncol, 4, pp.1490~1495 (2009)
  21. Liu M, "Discrepancy of epidermal growth factor receptor mutation in lung adenocarcinoma presenting as multiple ground-glass opacities", Eur J Cardiothorac Surg, 50, pp.909~913 (2016)
  22. Detterbeck FC, "The IASLC Lung Cancer Staging Project : background data and proposals for the application of TNM staging rules to lung cancer presenting as multiple nodules with ground glass or lepidic features or a pneumonic type of involvement in the forthcoming eighth edition of the TNM classification", J Thorac Oncol, 11, pp.666~680 (2016)
  23. Li R, "Early metastasis detected in patients with multifocal pulmonary ground-glass opacities(GGOs)", Thorax, 73, pp.290~292 (2018)
  24. Lu W, "The impact of chemotherapy on persistent ground-glass nodules in pati-ents with lung adenocarcinoma", J Thorac Dis, 9, pp.4743~4749 (2017)
  25. Riely GJ, "Clinical course of patients with non-small cell lung cancer and epidermal growth factor receptor exon 19 and exon 21 mutations treated with gefitinib or erlotinib", Clin Cancer Res, 12, pp.839~844 (2006)
  26. Sun JM, "The different efficacy of gefitinib or erlotinib according to epidermal growth factor receptor exon 19 and exon 21 mutations in Korean non-small cell lung cancer patients", J Cancer Res Clin Oncol, 137, pp.687~694 (2011)
  27. Li Y, "Genomic characterisation of pulmonary subsolid nodules : mutational landscape and radiological features", Eur Respir J, 55, pp.2322~ (2020)
  28. Wood DE, "Lung cancer screening, version 3.2018, NCCN Clinical Practice Guidelines in Oncology", J Natl Compr Canc Netw, 16, pp.412~441 (2018)
  29. Kakinuma R, "Measurement of focal ground-glass opacity diameters on CT images : interobserver agreement in regard to identifying increases in the size of ground-glass opacities", Acad Radiol, 19, pp.389~394 (2012)
  30. Shigematsu H, "Clinical and biological features associated with epidermal growth factor receptor gene mutations in lung cancers", J Natl Cancer Inst, 97, pp.339~346 (2005)

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