2024 Asia Conference on Lung Cancer (ACLC) - Poster & ePosters-PP02.30

PP02.30 - Yu Jiang

Pdf Summary

The study explores the feasibility of using EGFR tyrosine kinase inhibitors (EGFR-TKIs) as induction therapy to allow minimally invasive radical surgery in patients with initially unresectable stage IIIA-N2 to IIIC non-small cell lung cancer (NSCLC) with sensitive EGFR mutations. Conducted at the First Affiliated Hospital of Guangzhou Medical University, it involved a retrospective cohort from January 2017 to December 2022. Patients included had stage cIIIA-N2 to IIIC NSCLC with either L858R or exon 19 deletion mutations and received at least two cycles of EGFR-TKIs before surgery.<br /><br />Among the 28 patients who underwent surgery, 89.3% had lobectomy and 10.7% had bilobectomy, with a median surgery duration of 140 minutes. The average blood loss was 20 ml, and dense adhesions or fibrosis occurred in 35.7% of cases. The median postoperative hospital stay was five days, and there was no surgical-related mortality. Only 14.3% experienced any postoperative complications, none severe.<br /><br />Major pathological response (MPR) was seen in 32.1% of cases, though no complete pathological responses (pCR) were observed. Radiographic partial responses were noted in 60.7% of patients, while stable disease was noted in 39.3%. Lymph node downstaging occurred in 50% of patients. The median disease-free survival post-surgery was 58.6 months, although overall survival data is incomplete.<br /><br />This study highlights that EGFR-TKI induction therapy can effectively downstage lymph nodes and render initially unresectable NSCLC resectable. The subsequent radical surgeries demonstrated low mortality, morbidity, and favorable long-term disease control. The findings suggest EGFR-TKI therapies may significantly improve surgical outcomes and survival prospects in advanced NSCLC patients.

Keywords

EGFR tyrosine kinase inhibitors

induction therapy

NSCLC

EGFR mutations

minimally invasive surgery

retrospective cohort

lobectomy

pathological response

lymph node downstaging

disease-free survival