Journal
JOURNAL OF TRANSLATIONAL MEDICINE
Volume 13, Issue -, Pages -Publisher
BMC
DOI: 10.1186/s12967-015-0622-x
Keywords
Liver metastasis; Non-small cell lung cancer (NSCLC); Epidermal growth factor receptor (EGFR); EGFR tyrosin-kinase inhibitors; Prognosis
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Funding
- UTE project CIMA
- Spanish Ministry of Science and Innovation [ISCIII-PI11/00976]
- Red Tematica de Investigacion Cooperativa en Cancer [RD12/0036/0040]
- Instituto de Salud Carlos III
- Spanish Ministry of Economy and Competitiveness
- European Regional Development Fund Una manera de hacer Europa
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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 Clinica 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.
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