Clinical Research Papers:
Epidermal growth factor receptor is associated with the onset of skeletal related events in non-small cell lung cancer
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Shu-Mei Huang1,2, Jin-Ji Yang2, Hua-Jun Chen2, Si-Pei Wu2, Xiao-Yan Bai2, Qing Zhou2, Hai-Yan Tu2 and Yi-Long Wu1,2
1 Southern Medical University, Guangzhou, Guangdong, P.R. China
2 Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P.R. China
Yi-Long Wu, email:
Keywords: non-small cell lung cancer, epidermal growth factor receptor, tyrosine kinase inhibitors, bone metastasis, skeletal related events
Received: February 21, 2017 Accepted: May 15, 2017 Published:June 28, 2017
Background : Bone metastasis and skeletal related events (SREs) are common in non-small cell lung cancer (NSCLC). Patients with mutant epidermal growth factor receptor (EGFR) could benefit from tyrosine kinase inhibitors (TKIs). However, it is unclear whether SRE is influenced by EGFR status. We aimed to evaluate the correlation of EGFR status and TKIs with the incidence of SREs.
Methods : We conducted a retrospective study of stage IV NSCLC patients with bone metastasis. Incidence rate of SREs was collected and was compared using chi-square test. Logistic-regression analysis was used to identify the risk factors predicting the incidence of SREs.
Results :410 eligible patients were enrolled in the study. 49.0% were detected with EGFR mutation. 49.8% of patients received EGFR-TKIs therapy prior to the onset of SREs. 42.7% experienced at least one SRE. Patients who were treated with TKIs held lower incidence of SREs than patients who were not treated with TKIs (23.5% vs 61.7%, p<0.001). Multivariate analysis showed that poor performance status (OR 5.550, 95%CI 2.290-13.450; p<0.001) and mutant EGFR (OR 3.050, 95%CI 1.608-5.787, p=0.001) were independent risk factors predicting the onset of SREs, while the usage of TKIs (OR 0.102, 95%CI 0.054-0.193, p<0.001) was a protective factor of SREs in NSCLC patients with bone metastasis.
Conclusions : This study indicates that the incidence of SREs is common in both patients with and without EGFR mutation. Poor performance ability and mutant EGFR imply higher risks of SREs, while the usage of TKIs may be a protective factor of SREs.
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