High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases
ObjectivesThe prevalence of Skeletal Related Adverse Events (SREs) in EGFR mutated non-small cell lung cancer (NSCLC) patients with bone metastases, treated with modern tyrosine kinase inhibitors (TKIs), has been scarcely investigated.Materials and MethodsWe retrospectively evaluated the data of EGF...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.588862/full |
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| author | Marta Laganà Cristina Gurizzan Elisa Roca Diego Cortinovis Diego Signorelli Filippo Pagani Anna Bettini Lucia Bonomi Silvia Rinaldi Rossana Berardi Marco Filetti Raffaele Giusti Sara Pilotto Michele Milella Salvatore Intagliata Alice Baggi Alessio Cortellini Hector Soto Parra Matteo Brighenti Fausto Petrelli Chiara Bennati Paolo Bidoli Marina Chiara Garassino Alfredo Berruti |
| author_facet | Marta Laganà Cristina Gurizzan Elisa Roca Diego Cortinovis Diego Signorelli Filippo Pagani Anna Bettini Lucia Bonomi Silvia Rinaldi Rossana Berardi Marco Filetti Raffaele Giusti Sara Pilotto Michele Milella Salvatore Intagliata Alice Baggi Alessio Cortellini Hector Soto Parra Matteo Brighenti Fausto Petrelli Chiara Bennati Paolo Bidoli Marina Chiara Garassino Alfredo Berruti |
| author_sort | Marta Laganà |
| collection | DOAJ |
| description | ObjectivesThe prevalence of Skeletal Related Adverse Events (SREs) in EGFR mutated non-small cell lung cancer (NSCLC) patients with bone metastases, treated with modern tyrosine kinase inhibitors (TKIs), has been scarcely investigated.Materials and MethodsWe retrospectively evaluated the data of EGFR mutated NSCLC patients with bone metastases treated with TKIs in 12 Italian centers from 2014 to 2019, with the primary aim to explore type and frequency of SREs.ResultsSeventy-seven out of 274 patients enrolled (28%) developed at least one major SRE: 55/274 (20%) bone fractures, 30/274 (11%) spinal cord compression, 5/274 (2%) hypercalcemia. Median time to the onset of SRE was 3.63 months. Nine patients (3%) underwent bone surgery and 150 (55%) radiation therapy on bone. SREs were more frequently observed within the 12 months from TKI start than afterwards (71 vs 29%, p 0.000). Patient Performance Status and liver metastases where independently associated with the risk of developing SREs. Median TKI exposure and overall survival were 11 and 28 months, respectively. Bone resorption inhibitors were associated with a lower risk of death (HR 0.722, 95% CI: 0.504–1.033, p = 0.075) although not statistically significant at multivariate analysis.ConclusionBone metastatic NSCLC patients with EGFR mutated disease, treated with EGFR TKIs, have a relatively long survival expectancy and are at high risk to develop SREs. The early SRE occurrence after the TKI start provides the rationale to administer bone resorption inhibitors. |
| first_indexed | 2024-12-23T04:12:08Z |
| format | Article |
| id | doaj.art-208bb8be99a04d36b619cc111491842d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-23T04:12:08Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-208bb8be99a04d36b619cc111491842d2022-12-21T18:00:28ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-11-011010.3389/fonc.2020.588862588862High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone MetastasesMarta Laganà0Cristina Gurizzan1Elisa Roca2Diego Cortinovis3Diego Signorelli4Filippo Pagani5Anna Bettini6Lucia Bonomi7Silvia Rinaldi8Rossana Berardi9Marco Filetti10Raffaele Giusti11Sara Pilotto12Michele Milella13Salvatore Intagliata14Alice Baggi15Alessio Cortellini16Hector Soto Parra17Matteo Brighenti18Fausto Petrelli19Chiara Bennati20Paolo Bidoli21Marina Chiara Garassino22Alfredo Berruti23Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyMedical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyMedical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyMedical Oncology, Ospedale S. Gerardo di Monza, Monza, ItalyMedical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, ItalyMedical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, ItalyMedical Oncology, ASST Papa Giovanni XXIII di Bergamo, Bergamo, ItalyMedical Oncology, ASST Papa Giovanni XXIII di Bergamo, Bergamo, ItalyMedical Oncology, Ospedali Riuniti di Ancona, Ancona, ItalyMedical Oncology, Ospedali Riuniti di Ancona, Ancona, ItalyMedical Oncology, Azienda Ospedaliero Universitaria S. Andrea di Roma, Roma, ItalyMedical Oncology, Azienda Ospedaliero Universitaria S. Andrea di Roma, Roma, ItalyMedical Oncology, Università degli studi di Verona, Azienda Ospedaliera Universitaria Integrata, Verona, ItalyMedical Oncology, Università degli studi di Verona, Azienda Ospedaliera Universitaria Integrata, Verona, ItalyMedical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyMedical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyMedical Oncology, Ospedale San Salvatore di L’Aquila, L’Aquila, ItalyMedical Oncology, Policlinico Vittorio Emanuele di Catania, Catania, Italy0Medical Oncology, Ospedale di Cremona, Cremona, Italy1Ospedale Treviglio, ASST Bergamo Ovest, Treviglio, Italy2Ospedale Santa Maria delle Croci di Ravenna, Ravenna, ItalyMedical Oncology, Ospedale S. Gerardo di Monza, Monza, ItalyMedical Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, ItalyMedical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, ItalyObjectivesThe prevalence of Skeletal Related Adverse Events (SREs) in EGFR mutated non-small cell lung cancer (NSCLC) patients with bone metastases, treated with modern tyrosine kinase inhibitors (TKIs), has been scarcely investigated.Materials and MethodsWe retrospectively evaluated the data of EGFR mutated NSCLC patients with bone metastases treated with TKIs in 12 Italian centers from 2014 to 2019, with the primary aim to explore type and frequency of SREs.ResultsSeventy-seven out of 274 patients enrolled (28%) developed at least one major SRE: 55/274 (20%) bone fractures, 30/274 (11%) spinal cord compression, 5/274 (2%) hypercalcemia. Median time to the onset of SRE was 3.63 months. Nine patients (3%) underwent bone surgery and 150 (55%) radiation therapy on bone. SREs were more frequently observed within the 12 months from TKI start than afterwards (71 vs 29%, p 0.000). Patient Performance Status and liver metastases where independently associated with the risk of developing SREs. Median TKI exposure and overall survival were 11 and 28 months, respectively. Bone resorption inhibitors were associated with a lower risk of death (HR 0.722, 95% CI: 0.504–1.033, p = 0.075) although not statistically significant at multivariate analysis.ConclusionBone metastatic NSCLC patients with EGFR mutated disease, treated with EGFR TKIs, have a relatively long survival expectancy and are at high risk to develop SREs. The early SRE occurrence after the TKI start provides the rationale to administer bone resorption inhibitors.https://www.frontiersin.org/articles/10.3389/fonc.2020.588862/fullbone metastasisnon-small cell lung cancerskeletal related eventstyrosine kinase inhibitorsepidermal growth factor receptor |
| spellingShingle | Marta Laganà Cristina Gurizzan Elisa Roca Diego Cortinovis Diego Signorelli Filippo Pagani Anna Bettini Lucia Bonomi Silvia Rinaldi Rossana Berardi Marco Filetti Raffaele Giusti Sara Pilotto Michele Milella Salvatore Intagliata Alice Baggi Alessio Cortellini Hector Soto Parra Matteo Brighenti Fausto Petrelli Chiara Bennati Paolo Bidoli Marina Chiara Garassino Alfredo Berruti High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases Frontiers in Oncology bone metastasis non-small cell lung cancer skeletal related events tyrosine kinase inhibitors epidermal growth factor receptor |
| title | High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases |
| title_full | High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases |
| title_fullStr | High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases |
| title_full_unstemmed | High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases |
| title_short | High Prevalence and Early Occurrence of Skeletal Complications in EGFR Mutated NSCLC Patients With Bone Metastases |
| title_sort | high prevalence and early occurrence of skeletal complications in egfr mutated nsclc patients with bone metastases |
| topic | bone metastasis non-small cell lung cancer skeletal related events tyrosine kinase inhibitors epidermal growth factor receptor |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.588862/full |
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