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KMID : 0939920220540030817
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대한암학회지
2022 Volume.54 No. 3 p.817 ~ p.826
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The Impact of EGFR Tyrosine Kinase Inhibitor on the Natural Course of Concurrent Subsolid Nodules in Patients with Non?Small Cell Lung Cancer
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Kang No-Eul
Kim Ki-Hwan
Jeong Byeong-Ho
Lee Kyung-Jong
Kim Ho-Joong
Kwon O-Jung
Ahn Myung-Ju
Cho Jeong-Hee
Lee Ho-Yun
Um Sang-Won
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Abstract
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Purpose: The role of epidermal growth factor receptor?tyrosine kinase inhibitors (EGFR-TKIs) in the management of persistent subsolid nodules (SSNs) is unclear. This study aimed to investigate the impact of EGFR-TKIs on concurrent SSNs in patients with stage IV non?small cell lung cancer (NSCLC).
Materials and Methods: Patients who received an EGFR-TKI for at least 1 month for stage IV NSCLC and had concurrent SSN(s) that had existed for at least 3 months on chest computed tomography were included in this retrospective study. Size change of each nodule before and after EGFR-TKI therapies were evaluated using a cutoff value of 2 mm; increase (≥ 2 mm), decrease (≤ ?2 mm), and no change (?2 mm < size change < +2 mm).
Results: A total of 77 SSNs, 51 pure ground-glass (66.2%) and 26 part-solid nodules (33.8%), were identified in 59 patients who received gefitinib (n=45) and erlotinib (n=14). Among 58 EGFR mutation analysis performed for primary lung cancer, 45 (77.6%) were EGFR mutant. The proportions of decrease group were 19.5% (15/77) on per-nodule basis and 25.4% (15/59) on per-patient basis. Four SSNs (5.2%) disappeared completely. On per-patient based multivariable analysis, EGFR exon 19 deletion positivity for primary lung cancer was associated with a decrease after initial EGFR-TKI therapy (adjusted odds ratio, 4.29; 95% confidence interval, 1.21 to 15.29; p=0.025).
Conclusion: Approximately 20% of the concurrent SSNs decreased after the initial EGFR-TKI therapy. EGFR exon 19 deletion positivity for primary lung cancer was significantly associated with the size change of concurrent SSNs.
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KEYWORD
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EGFR-TKI, Subsolid nodule, Ground-glass nodule, Non-small-cell lung carcinoma, Size
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