Real world outcomes of EGFR-mutated non small cell lung cancer treated with surgery EXERPOS 02 GFPC study.

Abstract

e20002 Background: There are few epidemiological and clinical data’s on No Small Cell Lung Cancer (NSCLC) Caucasians patients (pts) harboring EGFR mutations treated by surgery. The primary objective of this study is to describe, in the real world setting the clinical, tumoral characteristics and the modality of disease recurrence of EGFR mutated NSCLC pts treated by surgery. Methods: Main inclusion criteria were: consecutive pts with early-stage NSCLC treated by surgery between January 2018 and December 2020 in France (Osimertinib was accessible as adjuvant therapy on 2022). Following data were collected: demographic and clinical data, surgery type, staging, disease recurrence, therapeutic approach at disease recurrence. EGFR status was carried out retrospectively when not available in the medical chart. Results: On the consecutives pts screened in 17 centers, 290 pts were EGFR mutated, median age: 68 (34-85) years, female 69%,never smokers 53%, adenocarcinoma 98%, PDL 1 status: 0%/1-49%/ > 50%: 61%/31 / 8%. Surgical resection was lobectomy, segmentectomy, wedge, pneumonectomy in 84%/13%/2%/1% of cases, respectively with complete lymph node dissection in 97% of cases; by video-thoracoscopy/ thoracotomy: robot assist 43%/, 43%/ 10%. (unknown 4%) of cases respectively. The quality of resection was R0/R1 in 97% and 3% of cases. Post-surgery staging was: IA: 46%, IB :16%, IIA: 3.5%, IIB:14%, IIIA: 18%, IIIB 2%. EGFR mutation exon was 19/21/20/18/others in 41%/ 40 %/12% /6%/1% of cases. Adjuvant treatment was administrated in 81/290 (28%) pts (chemotherapy, 61/290 (21%), EGFR TKI 17/290 (6%). After a median follow up 35 months, disease recurrence occurs in 89/290 (30%) pts (stages I,II,III: 32/178 (18%), 22/51 (43%), 33/57 (58%); metastatic progression occurs in 81% of cases (Brain, bone, pulmonary metastasis 26% /32%/ 29%). Median Disease free survival (mDFS) was: stage I: Not Reached 95%CI[NR-NR], stage II: 41 months, 95%CI[41-NR], stage III: 29 months 95%CI[23-44]. Conclusions: This real world analysis provides outcomes of EGFR mutated NSCLC treated by surgery.