title: Skeletal-related events in advanced lung adenocarcinoma patients evaluated EGFR mutations.
abstract: BACKGROUND
  The rate of lung cancer metastasis to the bone is high and skeletal-related events (SREs) decrease the quality of life in many patients. Recently, it was found that a subgroup of patients with non-small cell lung cancer (NSCLC) have specific mutations in the EGFR (epidermal growth factor receptor) gene. We assessed the SREs in advanced lung adenocarcinoma patients that evaluated EGFR mutations in whom bone metastasis was present.
  
  
  METHODS
  We retrospectively investigated the clinical records of 377 patients with advanced NSCLC. Patients were evaluated for the presence of EGFR mutations, bone metastases, the incidence of SREs, and treatment history before the first SRE.
  
  
  RESULTS
  A total of 78 patients who were evaluated for EGFR mutations had bone metastasis from lung adenocarcinoma. The most frequent site of bone metastasis was the spine (36.2%). SREs occurred in 37 patients (47.4%), the most common of which was bone radiotherapy (41.0%). Significant differences were not observed in the sites of bone metastases or the patterns of SREs between patients with and without EGFR mutations. The median time from bone metastasis to the first SRE was 5.8 months in all of the subjects, history of EGFR-tyrosine kinase inhibitor (TKI) treatment was significantly associated with longer median time to first SRE (14.2 months vs 1.3 months, p < 0.0001), and the median time to first SRE of patients with PS 0-1 was longer (8.5 months vs 0.9 months, p = 0.0023).
  
  
  CONCLUSIONS
  We found that SRE patterns have no difference between EGFR mutation positive and negative, and that the time from bone metastasis to the first SRE was longer in advanced lung adenocarcinoma patients with good PS and history of EGFR-TKI treatment.
authors.affiliation: Department of Respiratory Medicine, Osaka City University, Graduate School of Medicine, Japan. m2062345@med.osaka-cu.ac.jp
authors.forename: Misato
authors.initials: M
authors.lastname: Nagata
authors.forename: Shinzoh
authors.initials: S
authors.lastname: Kudoh
authors.forename: Shigeki
authors.initials: S
authors.lastname: Mitsuoka
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Suzumura
authors.forename: Kanako
authors.initials: K
authors.lastname: Umekawa
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tanaka
authors.forename: Kuniomi
authors.initials: K
authors.lastname: Matsuura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kimura
authors.forename: Naruo
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Kazuto
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology / Q000235:genetics* / Q000556:secondary* / Q000628:therapy; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000235:genetics* / Q000556:secondary* / Q000628:therapy; D016009:Chi-Square Distribution; D004164:Diphosphonates / Q000627:therapeutic use; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics* / Q000378:metabolism; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000201:enzymology / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D008297:Male; D058990:Molecular Targeted Therapy; D015999:Multivariate Analysis; D009154:Mutation; D010641:Phenotype; D011379:Prognosis; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors