Examination of the Effectiveness of Local Therapy for Oligo-recurrence of Epidermal Growth Factor Receptor-Mutated Non-Small Cell Lung Cancer

Abstract

Abstract Purpose The effectiveness of local therapy was recently reported in patients with non-small cell lung cancer (NSCLC) oligo-recurrence, a metachronous recurrence with a limited number of recurrences. Conversely, systemic therapy for NSCLC has made remarkable progress with the advent of molecular targeted therapy. In particular, epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) arevery effective in the treatment of EGFR-mutated NSCLC. This study aimed to evaluate the effectiveness of radical local therapy for oligo-recurrence in EGFR-mutated NSCLC. Methods Between 2004 and 2014, 811 patients underwent complete resection for NSCLC at Kitasato University Hospital, and 244 of these patients developed recurrence. Oligo-recurrence was defined as the presence of two or fewer recurrent lesions, and 34 patients presented with EGFR-mutated oligo-recurrence. We retrospectively examined and compared the effects of EGFR-TKIs with those of radical local therapy in patients with oligo-recurrent EGFR-mutated NSCLC. Results The five-year post-recurrence survival (PRS) rates of patients with EGFR-mutated oligo-recurrence who received radical local therapy (n = 23) and those who did not (n = 11) were 59.4% and 45.5%, respectively (P = 0.777). Multivariate analysis revealed no favorable prognostic factors associated with prolonged PRS, and radical local therapies did not improve PRS in patients with oligo-recurrence (P = 0.551). Conclusion Radical local therapy did not affect PRS in patients with oligo-recurrent EGFR-mutated NSCLC. Thus, even in cases of oligo-recurrence, the administration of local therapy in patients with EGFR-mutated NSCLC must be carefully considered.