EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany: An Observational Study

Research output: Contribution to journalArticleResearchpeer review

Authors

  • Wolfgang Schuette
  • Peter Schirmacher
  • Wilfried Ernst Erich Eberhardt
  • Juergen R. Fischer
  • J. Matthias Graf Von Der Schulenburg
  • Joerg Mezger
  • Christian Schumann
  • Monika Serke
  • Silke Zaun
  • Manfred Dietel
  • Michael Thomas

External Research Organisations

  • Hospital Martha-Maria
  • Heidelberg University
  • University of Duisburg-Essen
  • Klinik Löwenstein gGmbH
  • Ulm University
  • AstraZeneca
  • Charité - Universitätsmedizin Berlin
  • Translational Lung Research Center Heidelberg (TLRC-H)
  • St. Vincentius-Kliniken Karlsruhe
  • Lungenklinik Hemer
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Details

Original languageEnglish
Pages (from-to)1254-1261
Number of pages8
JournalCancer Epidemiology Biomarkers and Prevention
Volume24
Issue number8
Early online date12 Jul 2015
Publication statusPublished - Aug 2015

Abstract

Introduction: EGFR mutations confer sensitivity to EGFR tyrosine kinase inhibitors (TKI) in advanced non-small cell lung cancer (NSCLC). We investigated the clinicopathologic characteristics associated with EGFR mutations and their impact on realworld treatment decisions and outcomes in Caucasian patients with advanced NSCLC. Methods: REASON (NCT00997230) was a noninterventional multicenter study in patients (≥18 years) with stage IIIb/IV NSCLC, who were candidates for EGFR mutation testing and first-line systemic treatment, but not eligible for surgery or radiotherapy. Patients were followed up according to normal clinical practice and assessed for primary (correlation of mutation status with baseline characteristics) and secondary endpoints (first-line treatment decision). Results: Baseline data were obtained for 4,200 patients; 4,196 fulfilled the inclusion criteria; EGFR mutations were detected in 431 patients; no EGFR mutations were detected in 3,590 patients; mutation status was not evaluable in 175 patients. In multivariate analysis, the odds of EGFR mutations were significantly higher (P < 0.0001) in females versus males (odds ratio: 1.85; 95% confidence interval, 1.48-2.32), never-smokers versus smokers (3.64; 2.91-4.56), and patients with adenocarcinoma versus other histologic subtypes (2.94; 2.17-4.08). The most commonly prescribed first-line systemic treatments were: EGFR-TKIs in EGFR mutation-positive NSCLC (56.6%) and combination chemotherapy in EGFR mutation-negative NSCLC (78.5%). Conclusions: This represents the largest dataset for EGFR mutations in Caucasian patients and shows EGFR mutations to be most prevalent in females with adenocarcinoma who had never smoked. Impact: These findings add to our understanding of the prognostic and predictive factors of NSCLC, supporting future improved treatment selection.

ASJC Scopus subject areas

Sustainable Development Goals

Cite this

EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany: An Observational Study. / Schuette, Wolfgang; Schirmacher, Peter; Eberhardt, Wilfried Ernst Erich et al.
In: Cancer Epidemiology Biomarkers and Prevention, Vol. 24, No. 8, 08.2015, p. 1254-1261.

Research output: Contribution to journalArticleResearchpeer review

Schuette, W, Schirmacher, P, Eberhardt, WEE, Fischer, JR, Von Der Schulenburg, JMG, Mezger, J, Schumann, C, Serke, M, Zaun, S, Dietel, M & Thomas, M 2015, 'EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany: An Observational Study', Cancer Epidemiology Biomarkers and Prevention, vol. 24, no. 8, pp. 1254-1261. https://doi.org/10.1158/1055-9965.EPI-14-1149
Schuette, W., Schirmacher, P., Eberhardt, W. E. E., Fischer, J. R., Von Der Schulenburg, J. M. G., Mezger, J., Schumann, C., Serke, M., Zaun, S., Dietel, M., & Thomas, M. (2015). EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany: An Observational Study. Cancer Epidemiology Biomarkers and Prevention, 24(8), 1254-1261. https://doi.org/10.1158/1055-9965.EPI-14-1149
Schuette W, Schirmacher P, Eberhardt WEE, Fischer JR, Von Der Schulenburg JMG, Mezger J et al. EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany: An Observational Study. Cancer Epidemiology Biomarkers and Prevention. 2015 Aug;24(8):1254-1261. Epub 2015 Jul 12. doi: 10.1158/1055-9965.EPI-14-1149
Schuette, Wolfgang ; Schirmacher, Peter ; Eberhardt, Wilfried Ernst Erich et al. / EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany : An Observational Study. In: Cancer Epidemiology Biomarkers and Prevention. 2015 ; Vol. 24, No. 8. pp. 1254-1261.
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abstract = "Introduction: EGFR mutations confer sensitivity to EGFR tyrosine kinase inhibitors (TKI) in advanced non-small cell lung cancer (NSCLC). We investigated the clinicopathologic characteristics associated with EGFR mutations and their impact on realworld treatment decisions and outcomes in Caucasian patients with advanced NSCLC. Methods: REASON (NCT00997230) was a noninterventional multicenter study in patients (≥18 years) with stage IIIb/IV NSCLC, who were candidates for EGFR mutation testing and first-line systemic treatment, but not eligible for surgery or radiotherapy. Patients were followed up according to normal clinical practice and assessed for primary (correlation of mutation status with baseline characteristics) and secondary endpoints (first-line treatment decision). Results: Baseline data were obtained for 4,200 patients; 4,196 fulfilled the inclusion criteria; EGFR mutations were detected in 431 patients; no EGFR mutations were detected in 3,590 patients; mutation status was not evaluable in 175 patients. In multivariate analysis, the odds of EGFR mutations were significantly higher (P < 0.0001) in females versus males (odds ratio: 1.85; 95% confidence interval, 1.48-2.32), never-smokers versus smokers (3.64; 2.91-4.56), and patients with adenocarcinoma versus other histologic subtypes (2.94; 2.17-4.08). The most commonly prescribed first-line systemic treatments were: EGFR-TKIs in EGFR mutation-positive NSCLC (56.6%) and combination chemotherapy in EGFR mutation-negative NSCLC (78.5%). Conclusions: This represents the largest dataset for EGFR mutations in Caucasian patients and shows EGFR mutations to be most prevalent in females with adenocarcinoma who had never smoked. Impact: These findings add to our understanding of the prognostic and predictive factors of NSCLC, supporting future improved treatment selection.",
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T1 - EGFR Mutation Status and First-Line Treatment in Patients with Stage III/IV Non-Small Cell Lung Cancer in Germany

T2 - An Observational Study

AU - Schuette, Wolfgang

AU - Schirmacher, Peter

AU - Eberhardt, Wilfried Ernst Erich

AU - Fischer, Juergen R.

AU - Von Der Schulenburg, J. Matthias Graf

AU - Mezger, Joerg

AU - Schumann, Christian

AU - Serke, Monika

AU - Zaun, Silke

AU - Dietel, Manfred

AU - Thomas, Michael

PY - 2015/8

Y1 - 2015/8

N2 - Introduction: EGFR mutations confer sensitivity to EGFR tyrosine kinase inhibitors (TKI) in advanced non-small cell lung cancer (NSCLC). We investigated the clinicopathologic characteristics associated with EGFR mutations and their impact on realworld treatment decisions and outcomes in Caucasian patients with advanced NSCLC. Methods: REASON (NCT00997230) was a noninterventional multicenter study in patients (≥18 years) with stage IIIb/IV NSCLC, who were candidates for EGFR mutation testing and first-line systemic treatment, but not eligible for surgery or radiotherapy. Patients were followed up according to normal clinical practice and assessed for primary (correlation of mutation status with baseline characteristics) and secondary endpoints (first-line treatment decision). Results: Baseline data were obtained for 4,200 patients; 4,196 fulfilled the inclusion criteria; EGFR mutations were detected in 431 patients; no EGFR mutations were detected in 3,590 patients; mutation status was not evaluable in 175 patients. In multivariate analysis, the odds of EGFR mutations were significantly higher (P < 0.0001) in females versus males (odds ratio: 1.85; 95% confidence interval, 1.48-2.32), never-smokers versus smokers (3.64; 2.91-4.56), and patients with adenocarcinoma versus other histologic subtypes (2.94; 2.17-4.08). The most commonly prescribed first-line systemic treatments were: EGFR-TKIs in EGFR mutation-positive NSCLC (56.6%) and combination chemotherapy in EGFR mutation-negative NSCLC (78.5%). Conclusions: This represents the largest dataset for EGFR mutations in Caucasian patients and shows EGFR mutations to be most prevalent in females with adenocarcinoma who had never smoked. Impact: These findings add to our understanding of the prognostic and predictive factors of NSCLC, supporting future improved treatment selection.

AB - Introduction: EGFR mutations confer sensitivity to EGFR tyrosine kinase inhibitors (TKI) in advanced non-small cell lung cancer (NSCLC). We investigated the clinicopathologic characteristics associated with EGFR mutations and their impact on realworld treatment decisions and outcomes in Caucasian patients with advanced NSCLC. Methods: REASON (NCT00997230) was a noninterventional multicenter study in patients (≥18 years) with stage IIIb/IV NSCLC, who were candidates for EGFR mutation testing and first-line systemic treatment, but not eligible for surgery or radiotherapy. Patients were followed up according to normal clinical practice and assessed for primary (correlation of mutation status with baseline characteristics) and secondary endpoints (first-line treatment decision). Results: Baseline data were obtained for 4,200 patients; 4,196 fulfilled the inclusion criteria; EGFR mutations were detected in 431 patients; no EGFR mutations were detected in 3,590 patients; mutation status was not evaluable in 175 patients. In multivariate analysis, the odds of EGFR mutations were significantly higher (P < 0.0001) in females versus males (odds ratio: 1.85; 95% confidence interval, 1.48-2.32), never-smokers versus smokers (3.64; 2.91-4.56), and patients with adenocarcinoma versus other histologic subtypes (2.94; 2.17-4.08). The most commonly prescribed first-line systemic treatments were: EGFR-TKIs in EGFR mutation-positive NSCLC (56.6%) and combination chemotherapy in EGFR mutation-negative NSCLC (78.5%). Conclusions: This represents the largest dataset for EGFR mutations in Caucasian patients and shows EGFR mutations to be most prevalent in females with adenocarcinoma who had never smoked. Impact: These findings add to our understanding of the prognostic and predictive factors of NSCLC, supporting future improved treatment selection.

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