학술논문
Presentation and outcomes of KRASG12C mutant non-small cell lung cancer patients with stage IV disease at diagnosis (de novo) versus at recurrence
Document Type
article
Author
Niki Esfahanian; Sze Wah Samuel Chan; Luna J. Zhan; M.Catherine Brown; Khaleeq Khan; Jae Lee; Karmugi Balaratnam; Elizabeth Yan; Jennifer Parker; Miguel Garcia-Pardo; Samir H. Barghout; Lawson Eng; Penelope A. Bradbury; Frances A. Shepherd; Natasha B. Leighl; Adrian G. Sacher; Stephanie Snow; Rosalyn Juergens; Geoffrey Liu
Source
Cancer Treatment and Research Communications, Vol 37, Iss , Pp 100774- (2023)
Subject
Language
English
ISSN
2468-2942
Abstract
Close monitoring after diagnosis of patients with stage I-III non-small cell lung cancer (NSCLC) may result in fitter patients with lower disease burden at the time of metastatic recurrence or progression compared to patients diagnosed initially as stage IV (de novo). We compared the presentation, treatments, and outcomes of patients with KRASG12C-mutated NSCLC with de novo versus recurrent stage IV disease. Of 109 patients, 94% had a smoking history. When compared to patients with KRASG12C-mutated NSCLC who developed stage IV disease at recurrence (n = 38), de novo stage IV patients (n = 71) had worse ECOG performance status (p = 0.007), greater numbers of extra-thoracic metastatic sites (p = 0.001), and were less likely to receive 2nd/3rd line systemic therapy (p = 0.05, p = 0.002) or targeted therapy (p = 0.001). De novo metastatic patients had shorter overall survival than metastatic patients at recurrence (9.1 versus 24.2 months; adjusted-hazard-ratio=1.94 (95% CI: 1.14–3.28; p = 0.01)). There is a critical need for well-tolerated targeted therapies in the first-line setting for metastatic patients with de novo, high-burden, stage IV KRASG12C-mutated NSCLCs.