Background: Non-small cell lung cancer (NSCLC), particularly in advanced stages, has poor prognosis. The main objective of the study is to evaluate real-world treatment outcomes in advanced NSCLC patients harboring an EGFR mutation and being treated with TKIs.Methods: The EGFR mutation status was ascertained by next-generation sequencing. The observational cohort study used prospectively maintained registry data. Patient data were collected at two high-volume institutions in Austria between November 2020 and February 2025. The prevalence of EGFR mutations was 11% (145 out of 1267 patients).Results: Among 53 patients (stage IIIB or higher) with an EGFR mutation, median overall survival (OS) and median progression-free survival (PFS) were 17.7 months (95% CI: 10.4–24.9) and 14.2 months (95% CI: 7.4–20.9), respectively. A total of 36 patients harbored common EGFR mutations (exon 19 deletion or L858R point mutation) and exhibited a significantly better OS than those with an uncommon EGFR genotype (p< 0.005). Patients with exon 19 deletion (n= 25) showed the longest mOS, followed by those with L858R mutation (32.5 vs. 17 months). In multivariable analysis, the EGFR common mutation subtype (HR = 3.71 95%CI: 1.23–11.2) was associated with better OS. Patients with common EGFR genotypes, especially exon 19 deletion obtained longer OS and PFS compared with those with uncommon mutations in exon 18–21.Conclusions: The results underscore the prognostic role of distinct EGFR genotypes and the urgency of determining the mutation status in non-small cell lung cancer patients to ensure the best treatment decision. The study also highlights the challenges regarding to EGFR uncommon mutations and the resulting need for further research to investigate alternative treatment options.
背景：非小细胞肺癌（NSCLC）尤其在晚期阶段预后较差。本研究的主要目的是评估携带EGFR突变并接受酪氨酸激酶抑制剂（TKI）治疗的晚期NSCLC患者的实际治疗效果。方法：通过二代测序技术确定EGFR突变状态。该观察性队列研究使用前瞻性维护的登记数据。患者数据于2020年11月至2025年2月期间在奥地利两家大型医疗机构收集。EGFR突变发生率为11%（1267例患者中的145例）。结果：在53例EGFR突变的IIIB期或更高分期患者中，中位总生存期（OS）和中位无进展生存期（PFS）分别为17.7个月（95% CI：10.4–24.9）和14.2个月（95% CI：7.4–20.9）。共有36例患者携带常见EGFR突变（外显子19缺失或L858R点突变），其OS显著优于携带罕见EGFR基因型的患者（p<0.005）。外显子19缺失患者（n=25）的mOS最长，其次为L858R突变患者（32.5个月对比17个月）。多变量分析显示，EGFR常见突变亚型（HR=3.71，95%CI：1.23–11.2）与更好的OS相关。与外显子18–21罕见突变患者相比，携带常见EGFR基因型（尤其是外显子19缺失）的患者获得了更长的OS和PFS。结论：结果强调了特定EGFR基因型的预后价值，以及在非小细胞肺癌患者中明确突变状态以确保最佳治疗决策的紧迫性。本研究同时揭示了关于EGFR罕见突变面临的挑战，凸显了进一步研究替代治疗方案的必要性。
肿瘤(癌症)患者之家