Publicaciones científicas

Impact of epidermal growth factor receptor (EGFR) activating mutations and their targeted treatment in the prognosis of stage IV non-small cell lung cancer (NSCLC) patients harboring liver metastasis

Castañón E (1,2), Rolfo C (3), Viñal D (4), López I (5), Fusco JP (6), Santisteban M (7), Martin P (8), Zubiri L (9), Echeveste JI (10), Gil-Bazo I (11,12).
(1) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain.
(2) Program in Solid Tumors and Biomarkers, Center for Applied Medical Research (CIMA), Pamplona, Spain.
(3) Department of Oncology, Antwerp University Hospital UZA, Edegem, Belgium. Christian.
(4) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain. 
(5) Program in Solid Tumors and Biomarkers, Center for Applied Medical Research (CIMA), Pamplona, Spain.
(6) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain.
(7) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain.
(8) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain. 
(9) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain. 
(10) Department of Pathology, Clínica Universidad de Navarra, Pamplona, Spain.
(11) Department of Oncology, Clínica Universidad de Navarra, Avenida Pío XII, 36, 31008, Pamplona, Spain. 
(12) Program in Solid Tumors and Biomarkers, Center for Applied Medical Research (CIMA), Pamplona, Spain.  

Revista: Journal of Translational Medicine

Fecha: 07/08/2015

Anatomía Patológica Oncología Médica

OBJECTIVES

Liver metastases appear in 20-30% of patients diagnosed with non-small cell lung cancer (NSCLC) and represent a poor prognosis feature of NSCLC and a possibly more treatment-resistant condition. Potential clinical outcome differences in NSCLC patients with liver metastases harboring molecular alterations in EGFR, KRAS and EML4-ALK genes are still to be determined.

This study aims to evaluate the incidence of liver metastasis in a single population and look for potential correlations between EGFR mutations, liver infiltration and clinical outcomes.

METHODS

A total of 236 consecutive stage IV NSCLC patients treated at the Clínica Universidad de Navarra were analyzed.

RESULTS

At onset, liver metastases were present in 16.9% of patients conferring them a shorter overall survival (OS) compared to those with different metastatic locations excluding liver infiltration (10 vs. 21 months; p = 0.001). Patients with EGFR wild-type tumors receiving standard chemotherapy and showing no liver involvement presented a superior median OS compared to those with liver metastases (23 vs. 13 months; p = 0.001).

Conversely, patients with EGFR-mutated tumors treated with EGFR tyrosin-kinase inhibitors (TKI's) presented no significant differences in OS regardless of liver involvement (median OS not reached vs. 25 months; p = 0.81).

CONCLUSION

Overall, liver metastases at onset negatively impact OS of NSCLC patients. EGFR TKIs however, may reverse the effects of an initial negative prognosis of liver metastasis in first-line treatment of EGFR mutated NSCLC patients.

CITA DEL ARTÍCULO  J Transl Med. 2015 Aug 7;13:257. doi: 10.1186/s12967-015-0622-x 

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