WCLC 2025 - Posters & ePosters-P1.07.13 Impact of TP53 Co-Mutation in Resected Early-Stage EGFR-Mutated Lung Adenocarcinoma

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This study investigated the impact of TP53 co-mutation on clinicopathological features, prognosis, and recurrence patterns in patients with resected early-stage EGFR-mutated lung adenocarcinoma. The retrospective single-center study included 121 patients with common EGFR mutations who underwent anatomical complete resection between 2014 and 2018. Patients with uncommon EGFR mutations, wild-type EGFR, or those receiving adjuvant EGFR-TKIs or investigational drugs were excluded.<br /><br />TP53 co-mutations were found in 18.2% (22/121) of patients. These patients exhibited a significantly higher incidence of lymphovascular invasion (LVI) (50.0% vs. 25.3%, p=0.037) and higher tumor mutational burden (TMB). Other baseline characteristics such as age, sex, smoking history, tumor size, pathological stage, and EGFR mutation subtype were not significantly different between those with and without TP53 co-mutations.<br /><br />Importantly, TP53 co-mutation was associated with significantly worse recurrence-free survival (RFS) and overall survival (OS). After adjusting for age, sex, and pathological stage, hazard ratios were 2.32 (p=0.025) for RFS and 2.54 (p=0.047) for OS, indicating over twofold higher risk of relapse and death compared to TP53 wild-type patients. There was no significant difference in the initial sites of recurrence or subsequent treatments after relapse between groups, but the small sample size limited analysis of responses to EGFR-TKIs post-recurrence.<br /><br />The study concludes that TP53 co-mutation potentially drives more aggressive disease behavior through increased lymphovascular invasion, leading to poorer prognosis after surgical resection of early-stage EGFR-mutated lung adenocarcinoma. This is the first study demonstrating a negative impact of TP53 co-mutations on overall survival in this context. Limitations include its retrospective design, single-center setting, and small sample size restricting analysis of TP53 mutation subtypes. Further research is needed to validate these findings and clarify the role of TP53 mutations in guiding postoperative treatment strategies.

Asset Subtitle

Tatsuya Masuda

Meta Tag

Speaker Tatsuya Masuda

Topic Early-Stage Non-small Cell Lung Cancer

Keywords

TP53 co-mutation

EGFR-mutated lung adenocarcinoma

early-stage lung cancer

lymphovascular invasion

tumor mutational burden

recurrence-free survival

overall survival

prognosis

surgical resection

retrospective study