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Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors

BACKGROUND: Choroidal metastases are the most common eye metastatic site. The prevalence of choroidal metastases in NSCLC patients has been reported to vary from 0.2 to 7% in historical series. Although previously reported, little is known about choroidal metastasis in Epidermal Growth Factor Recept...

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Autores principales: Bouchez, Clémentine, Pluvy, Johan, Soussi, Ghassen, Nguenang, Marina, Brosseau, Solenn, Tourne, Morgan, Collin, Mégane, Théou-Anton, Nathalie, Guyard, Alice, Ammar, Jamila, Khalil, Antoine, Zalcman, Gérard, Gounant, Valérie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712981/
https://www.ncbi.nlm.nih.gov/pubmed/33272243
http://dx.doi.org/10.1186/s12885-020-07630-6
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author Bouchez, Clémentine
Pluvy, Johan
Soussi, Ghassen
Nguenang, Marina
Brosseau, Solenn
Tourne, Morgan
Collin, Mégane
Théou-Anton, Nathalie
Guyard, Alice
Ammar, Jamila
Khalil, Antoine
Zalcman, Gérard
Gounant, Valérie
author_facet Bouchez, Clémentine
Pluvy, Johan
Soussi, Ghassen
Nguenang, Marina
Brosseau, Solenn
Tourne, Morgan
Collin, Mégane
Théou-Anton, Nathalie
Guyard, Alice
Ammar, Jamila
Khalil, Antoine
Zalcman, Gérard
Gounant, Valérie
author_sort Bouchez, Clémentine
collection PubMed
description BACKGROUND: Choroidal metastases are the most common eye metastatic site. The prevalence of choroidal metastases in NSCLC patients has been reported to vary from 0.2 to 7% in historical series. Although previously reported, little is known about choroidal metastasis in Epidermal Growth Factor Receptor (EGFR)-mutant Non-small cell lung cancer (NSCLC). This study sought to describe the prevalence of choroidal metastases among patients with EGFR-mutated NSCLC and their characteristics, and to estimate their impact on prognosis. METHODS: We conducted a single-center retrospective study including all consecutive metastatic EGFR-mutant NSCLC patients, from Sept. 2015 to Oct. 2018. The EGFR-mutant NSCLC patients were identified via the Department of Genetics’ files. Patients who exhibited choroidal metastases were compared to patients without choroidal metastases. Kaplan-Meier analysis and log-rank test were conducted to assess median overall survival (OS) from diagnosis for the two groups. The study was approved by the IRB as CEPRO number #2020–010. RESULTS: Prevalence of choroidal metastases in EGFR-mutated NSCLCs was 8.4% (7/83). Five were women, and four current or former smokers. Molecular analysis showed three tumors with exon 19 deletion, three with L858R mutation, and one with complex exon 21 mutation. The choroidal metastases were symptomatic in six/seven patients. Visual disturbances decreased in all but one symptomatic cases upon EGFR TKI, and the choroidal response was maintained over time. Median follow-up was 42.2 mo (95%CI [37.2–47.1]). Median OS in the choroidal metastasis group was 23.4 mo (95%CI [0.1–51.4]) versus 27.9 mo (95%CI [16.9–38.9]) in the non-choroidal metastasis group (p = 0.32). In the choroidal metastasis group, 2-year and 5-year OS were 47.6 and 0%, respectively, versus 55.8 and 26.3% in the non-choroidal metastasis subset. CONCLUSIONS: Choroidal metastases in NSCLC EGFR-mutant patients are rare but should be systematically suspected in case of visual disturbance. TKIs are efficient for treating visual symptoms. Whether choroidal metastases confer a worse prognosis remains unclear owing to the third-generation EGFR TKI osimertinib first-line registration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-020-07630-6.
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spelling pubmed-77129812020-12-03 Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors Bouchez, Clémentine Pluvy, Johan Soussi, Ghassen Nguenang, Marina Brosseau, Solenn Tourne, Morgan Collin, Mégane Théou-Anton, Nathalie Guyard, Alice Ammar, Jamila Khalil, Antoine Zalcman, Gérard Gounant, Valérie BMC Cancer Research Article BACKGROUND: Choroidal metastases are the most common eye metastatic site. The prevalence of choroidal metastases in NSCLC patients has been reported to vary from 0.2 to 7% in historical series. Although previously reported, little is known about choroidal metastasis in Epidermal Growth Factor Receptor (EGFR)-mutant Non-small cell lung cancer (NSCLC). This study sought to describe the prevalence of choroidal metastases among patients with EGFR-mutated NSCLC and their characteristics, and to estimate their impact on prognosis. METHODS: We conducted a single-center retrospective study including all consecutive metastatic EGFR-mutant NSCLC patients, from Sept. 2015 to Oct. 2018. The EGFR-mutant NSCLC patients were identified via the Department of Genetics’ files. Patients who exhibited choroidal metastases were compared to patients without choroidal metastases. Kaplan-Meier analysis and log-rank test were conducted to assess median overall survival (OS) from diagnosis for the two groups. The study was approved by the IRB as CEPRO number #2020–010. RESULTS: Prevalence of choroidal metastases in EGFR-mutated NSCLCs was 8.4% (7/83). Five were women, and four current or former smokers. Molecular analysis showed three tumors with exon 19 deletion, three with L858R mutation, and one with complex exon 21 mutation. The choroidal metastases were symptomatic in six/seven patients. Visual disturbances decreased in all but one symptomatic cases upon EGFR TKI, and the choroidal response was maintained over time. Median follow-up was 42.2 mo (95%CI [37.2–47.1]). Median OS in the choroidal metastasis group was 23.4 mo (95%CI [0.1–51.4]) versus 27.9 mo (95%CI [16.9–38.9]) in the non-choroidal metastasis group (p = 0.32). In the choroidal metastasis group, 2-year and 5-year OS were 47.6 and 0%, respectively, versus 55.8 and 26.3% in the non-choroidal metastasis subset. CONCLUSIONS: Choroidal metastases in NSCLC EGFR-mutant patients are rare but should be systematically suspected in case of visual disturbance. TKIs are efficient for treating visual symptoms. Whether choroidal metastases confer a worse prognosis remains unclear owing to the third-generation EGFR TKI osimertinib first-line registration. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-020-07630-6. BioMed Central 2020-12-03 /pmc/articles/PMC7712981/ /pubmed/33272243 http://dx.doi.org/10.1186/s12885-020-07630-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Bouchez, Clémentine
Pluvy, Johan
Soussi, Ghassen
Nguenang, Marina
Brosseau, Solenn
Tourne, Morgan
Collin, Mégane
Théou-Anton, Nathalie
Guyard, Alice
Ammar, Jamila
Khalil, Antoine
Zalcman, Gérard
Gounant, Valérie
Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title_full Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title_fullStr Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title_full_unstemmed Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title_short Epidermal growth factor receptor-mutant non-small cell lung Cancer and Choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
title_sort epidermal growth factor receptor-mutant non-small cell lung cancer and choroidal metastases: long-term outcome and response to epidermal growth factor receptor tyrosine kinase inhibitors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712981/
https://www.ncbi.nlm.nih.gov/pubmed/33272243
http://dx.doi.org/10.1186/s12885-020-07630-6
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