Clinical Outcomes and Safety of Concurrent Chemoradiotherapy in EGFR-Mutant Unresectable Stage III NSCLC

This is the authors' abstract. We don't add key points for this paper.

Concurrent chemoradiotherapy (cCRT) is a standard-of-care for unresectable stage III non-small cell lung cancer (NSCLC), but whether epidermal growth factor receptor ( EGFR ) mutation is prognostic factor remains unclear. This study evaluated the efficacy and safety of cCRT in unresectable stage III EGFR -mutant NSCLC. This study aimed to describe and compare the efficacy and safety outcomes of unresectable stage III NSCLC treated with cCRT in those with and without EGFR mutation. Data from three randomized phase II trials in the Japan Lung Cancer Society database (n = 274; 116 EGFR -mutant, 158 EGFR wild-type) were analyzed. Outcomes were progression-free survival (PFS), overall survival (OS), and safety. EGFR -mutant NSCLC exhibited significantly shorter PFS than EGFR wild-type NSCLC (hazard ratio [HR] = 1.38; 95% confidence interval [CI]: 1.05–1.82; P = 0.021). The results were generally consistent without statistical deviation, regardless of subgroup characteristics. EGFR mutation was retained as a covariate in the final multivariate model for PFS (HR = 1.358; 95% CI: 0.977–1.886; P = 0.068). OS was not significantly different between the groups (HR = 0.98; 95% CI: 0.70–1.38; P = 0.903). A higher incidence of Grade 3–4 pneumonitis was observed in EGFR -mutant NSCLC compared with EGFR wild-type NSCLC (7.8% vs. 2.6%). EGFR -mutant unresectable stage III NSCLC exhibited significantly shorter PFS than EGFR wild-type NSCLC. The median PFS was generally consistent with that of the control arm in the LAURA trial. Increased pneumonitis risk necessitates close monitoring in EGFR -mutant unresectable stage III NSCLC.