Three-Year Follow-Up of a Randomized Phase II Trial on Refinement of Early-Stage NSCLC Adjuvant Chemotherapy with Cisplatin and Pemetrexed versus Cisplatin and Vinorelbine (the TREAT Study)

Adjuvant chemotherapy in non-small cell lung cancer (NSCLC) improves survival but is associated with significant toxicity. The Randomized Phase II Trial on Refinement of Early-Stage NSCLC Adjuvant Chemotherapy with Cisplatin and Pemetrexed versus Cisplatin and Vinorelbine (TREAT study) was designed to test the hypothesis that a protocol with reduced toxicity might improve feasibility of postoperative delivery of adjuvant chemotherapy drugs to patients with NSCLC, thereby improving compliance and, potentially, survival.publisher: Elsevier articletitle: Three-Year Follow-Up of a Randomized Phase II Trial on Refinement of Early-Stage NSCLC Adjuvant Chemotherapy with Cisplatin and Pemetrexed versus Cisplatin and Vinorelbine (the TREAT Study) journaltitle: Journal of Thoracic Oncology articlelink: http://dx.doi.org/10.1016/j.jtho.2015.09.014 content_type: article copyright: Copyright © 2015 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.status: publishe

CT characteristics in pulmonary adenocarcinoma with epidermal growth factor receptor mutation

<div><p>Comprehensively investigate the association of CT morphology and clinical findings of adenocarcinoma with <i>EGFR</i> mutation status. Retrospectively included 282 patients who was pathologically proved as lung adenocarcinoma with known <i>EGFR</i> mutation status (mutations: 138 patients, female: 86, median age: 66 years; wildtype: 144 patients, female: 67, median age: 62 years) and their pre-treatment CT scans were analyzed. CT findings and clinical information were collected. Univariate and multivariable logistic regression analysis were performed. Adjusted for age, gender and smoking history of two groups, significantly more patients with pleural tags, pleural and liver metastases were found in the <i>EGFR</i> mutated group (<i>P</i> = 0.007, 0.004, and 0.043, respectively). Multivariable logistic regression analysis found that the model included age, gender, smoking history, air bronchogram, pleural tags, pleural and liver metastasis had a moderate predictive value for <i>EGFR</i> mutation status (AUC = 0.741, <i>P</i> < .0001). Exon-19 deletion was associated with air bronchogram which adjusted for age, gender and smoking history (<i>P</i> = 0.007, OR: 2.91, 95%CI: 1.25–7.79). The evidence of pleural tags, pleural and liver metastases go along with a higher probability of <i>EGFR</i> mutation in adenocarcinoma patients and air bronchogram is positively associated with Exon-19 deletion mutation.</p></div

S1 data (EGFR wildtype mutation).xls

the primary data of included ADC patients with EGFR wildtype mutatio

Transversal CT images of pulmonary adenocarcinoma with examples of the morphological features under investigation.

<p>(A) Central lesion with tumor-bearing lobe atelectasis; (B) peripheral cavitary solid mass with ovoid shape, predominant spiculated margins and associated pleural tags (arrow); (C) central irregular semi-solid lesion in smooth margin with air bronchogram (arrow), GGO account for 25%-50%; (D) peripheral lesion with irregular shape, air bronchogram (arrow) and pleural tag (arrowhead); (E) central solid lesion with irregular shape and predominant lobulated margins with bilateral pulmonary metastases (arrows); (F) Irregular shape tumor after contrast enhancement showed central necrosis (arrow) and contralateral mediastinal lymph node metastasis (arrowhead); (G) tumor-side pleural metastases (arrows); (H) liver, bone, and bilateral adrenal gland metastases (arrows).</p

Within <i>EGFR</i> mutation group, significant correlations of deletion in exon 19 or p.L 858R with clinical and CT features.

<p>Within <i>EGFR</i> mutation group, significant correlations of deletion in exon 19 or p.L 858R with clinical and CT features.</p

The percentage composition of the detected <i>EGFR</i> mutations.

<p></p><p></p><p></p><p><i>Note</i>:<i>- Combined EGFR mutation stands for mutation at least was found in two exons (18–21)</i>, <i>for example point mutation in 18 and 20 exons</i>.</p><p></p><p></p><p><i>        - Seldom mutation means at least two combination of the way of EGFR mutation</i>, <i>such as deletion combined insertion in exon 19</i>.</p><p></p><p></p><p><i>        - There was one patients had both deletion in exon 19 and p</i>.<i>L858R</i>.</p><p></p><p></p><p></p> <p><i>Note</i>:<i>- Combined EGFR mutation stands for mutation at least was found in two exons (18–21)</i>, <i>for example point mutation in 18 and 20 exons</i>.</p> <p><i>        - Seldom mutation means at least two combination of the way of EGFR mutation</i>, <i>such as deletion combined insertion in exon 19</i>.</p> <p><i>        - There was one patients had both deletion in exon 19 and p</i>.<i>L858R</i>.</p

Receiver operator characteristic curve for the model which composed by age, gender, smoking history, air bronchogram, pleural tags, pleural and liver metastasis to predict <i>EGFR</i> mutation status.

<p>The area under the curve is 0.741.</p

Statistically significant imaging characteristics comparison between <i>EGFR</i> mutation statuses.

<p>Statistically significant imaging characteristics comparison between <i>EGFR</i> mutation statuses.</p

Clinical characteristics of <i>EGFR</i> mutation (M) and wildtype (wt) cohorts.

<p>Clinical characteristics of <i>EGFR</i> mutation (M) and wildtype (wt) cohorts.</p