Association of molecular status and metastatic organs at diagnosis in patients with stage IV non-squamous non-small cell lung cancer

Autor: Chantal C H J Kuijpers, Stefan M. Willems, Jules L. Derks, Ronald A M Damhuis, M. van den Heuvel, Lizza E.L. Hendriks, A. Van Lindert, Anne-Marie C. Dingemans
Přispěvatelé: RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Pulmonologie, Promovendi ODB, MUMC+: MA Med Staf Spec Longziekten (9), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Oncology
Male
Cancer Research
Lung Neoplasms
DNA Mutational Analysis
medicine.disease_cause
0302 clinical medicine
Molecular status
Non-small cell lung cancer
Carcinoma
Non-Small-Cell Lung
Pathology
Anaplastic Lymphoma Kinase
Registries
Neoplasm Metastasis
Pathology
Molecular
Prospective cohort study
Netherlands
Non-Small-Cell Lung/diagnosis
Middle Aged
medicine.anatomical_structure
030220 oncology & carcinogenesis
Cohort
Adenocarcinoma
Female
KRAS
BONE
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Lung Neoplasms/diagnosis
Carcinoma
Non-Small-Cell Lung/diagnosis
Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9]
Genes
erbB-1/genetics
Proto-Oncogene Proteins p21(ras)/genetics
Proto-Oncogene Proteins p21(ras)
03 medical and health sciences
Internal medicine
medicine
Humans
erbB-1/genetics
Lung cancer
Aged
Neoplasm Staging
Lung
business.industry
Bone metastases
EGFR MUTATIONS
Carcinoma
Metastatic organs
Molecular
ADENOCARCINOMA
Odds ratio
Genes
erbB-1
Anaplastic Lymphoma Kinase/genetics
medicine.disease
Survival Analysis
Cancer registry
030104 developmental biology
Genes
CLINICAL-PRACTICE
business
DISTANT METASTASES
Follow-Up Studies
Zdroj: Lung Cancer, 121, 76. Elsevier Ireland Ltd
Lung Cancer, 121, pp. 76-81
Lung Cancer, 121, 76-81
Lung Cancer, 121, 76-81. Elsevier Ireland Ltd
Lung Cancer, 121, 76-81. ELSEVIER IRELAND LTD
ISSN: 0169-5002
Popis: Contains fulltext : 193662.pdf (Publisher’s version ) (Open Access) OBJECTIVES: Biological predisposition for specific metastatic organs might differ between molecular subgroups of lung cancer. We aimed to assess the association between molecular status and metastatic organs at diagnosis in a nationwide stage IV non-squamous non-small cell lung cancer ((ns)-NSCLC) cohort. METHODS: All ns-NSCLC from 2013 that were stage IV at diagnosis were identified from the Netherlands Cancer Registry, which records information on metastatic organs at diagnosis. Tumors were matched to the Dutch Pathology Registry (PALGA) from which data on molecular status established in routine practice was extracted. Four molecular subgroups (EGFR+, KRAS+, ALK+, triple-negative) were identified. For each metastatic organ, proportions of tumors metastasized to this organ were, per molecular subgroup, compared to triple-negative tumors by multivariable logistic regression analyses (adjusted odds ratios (OR) with 95% confidence intervals (CI)), taking clinicopathological variables into account. RESULTS: 160 EGFR+ (exon 19 del, exon 21 L858R), 784 KRAS+, 42 ALK+, and 1008 triple-negative tumors were identified. Most frequent metastatic organs were the bone (34%), pleura (24%), lung (23%), and brain (22%). Compared to triple-negatives, EGFR+ tumors had more often metastases to the bone (31.5 vs 53.8%; OR 2.55 (95% CI 1.80-3.62)) and pleura (24.1 vs 37.5%; OR 2.06 (1.42-2.98)), and less often to the brain (22.0 vs 12.5%; OR 0.53 (0.32-0.88)) and adrenal glands (19.1 vs 7.5%; OR 0.46 (0.28-0.75)). Compared to triple-negatives, KRAS+ and ALK+ tumors had at diagnosis metastasized more often to the lung (20.3 vs 26.7%; OR 1.40 (1.12-1.76)) and the liver (13.1 vs 23.8%; OR 2.07 (1.00-4.32)), respectively. CONCLUSION: NSCLC molecular status was associated with metastatic pattern at diagnosis. 54% of stage IV EGFR+ ns-NSCLC patients had bone metastases at diagnosis. These observational results are hypothesis generating, and call for a prospective study where EGFR+ patients are screened for bone metastases, and treated to prevent skeletal related events.
Databáze: OpenAIRE
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