• In the current study, the authors analyzed characteristics of patients treated with tyrosine kinase inhibitors (TKIs) with either de novo or secondary metastatic EGFR NSCLC.
• According to the authors, “A first important finding is that the setting of stage IV disease, de novo vs. secondary, itself is not associated with survival of EGFR NSCLC patients from the time of stage IV diagnosis: PFS under TKI or chemotherapy, and OS [overall survival] were similar among the two patient group. Furthermore, most other parameters known to be associated with OS of stage IV EGFR NSCLC, such as the histological subtype, type of EGFR mutation, TP53 status, presence of co-mutations, especially in TP53, frequency of T790M development, were equally distributed among de novo and secondary cases.”
• One limitation of the current study is a dearth of detailed data concerning patient symptoms at diagnosis. Another limitation may be the observed 1:4 ratio secondary to de novo metastatic EGFR NSCLC is not a biological characteristic, and thus impacted by methods of lung cancer detection.
Despite the survival advantage reported in the pre-TKI era for relapsed NSCLC, molecular features and outcome of TKI-treated metastatic EGFR + tumors are currently independent of preceding nonmetastatic disease. This simplifies design of outcome studies and can assist prognostic considerat ...