Survival Disparities in Black Patients With EGFR-mutated Non–small-cell Lung Cancer

Haiying Cheng, H. Dean Hosgood, Lei Deng, K. Ye, Christopher Su, Janaki N. Sharma, Yuanquan Yang, Balazs Halmos, R. Perez-Soler

Research output: Contribution to journalArticle

Abstract

Background: Little is known about the difference between black and non-black patients with epidermal growth factor receptor (EGFR)-mutated non–small-cell lung cancer (NSCLC), particularly regarding survival. We thus characterized the EGFR expression profile, clinical characteristics, and survival outcome in these patients. Patient and Methods: We reviewed the cancer registry and patient charts at a New York-Bronx network (n = 2773) treating a large population of minority patients, for non-squamous NSCLC (n = 1986) diagnosed between 2009 and 2015. Survival was adjusted for smoking, gender, age, weight, and stage. Results: The EGFR mutation rate was 15% (98/652) in tested patients (black, 14%; non-black, 16%). There was no significant difference between the 2 cohorts with respect to age at diagnosis, gender, presenting stages, and socioeconomic status. On the other hand, weight was noted to be heavier in black patients with EGFR-mutated NSCLC than their non-black counterparts (P = .012). After adjusting for gender, age, smoking status, weight, and stage, the multivariate analysis revealed no racial disparity in survival among patients with wild-type EGFR (P = .774); However, among patients with EGFR-mutated NSCLC, black patients had shorter survival in comparison with non-black patients (P = .001), with 2-year survival rates being 33% versus 61%, respectively. Such shorter survival was also observed among EGFR-inhibitor treated patients with common EGFR mutations (P = .040). Conclusions: To our knowledge, this is the first report of inferior survival among black patients with NSCLC with EGFR mutations, relative to non-black patients. The survival disparities suggest the need of more tailored management for this patient population. Non–small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation is a distinct molecular subgroup with effective targeted therapy. In our study of 2773 patients, the survival was similar between races among EGFR wild-type NSCLC; however, black patients with EGFR-mutant NSCLC had inferior survival compared with their non-black counterparts. More tailored management for this population is warranted.

Original languageEnglish (US)
JournalClinical Lung Cancer
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Epidermal Growth Factor Receptor
Non-Small Cell Lung Carcinoma
Survival
Weights and Measures
Mutation
Smoking
Population
Mutation Rate
Social Class
Registries

Keywords

  • Black patients
  • EGFR
  • Lung cancer
  • Survival
  • Uncommon EGFR mutations

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Survival Disparities in Black Patients With EGFR-mutated Non–small-cell Lung Cancer. / Cheng, Haiying; Hosgood, H. Dean; Deng, Lei; Ye, K.; Su, Christopher; Sharma, Janaki N.; Yang, Yuanquan; Halmos, Balazs; Perez-Soler, R.

In: Clinical Lung Cancer, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Little is known about the difference between black and non-black patients with epidermal growth factor receptor (EGFR)-mutated non–small-cell lung cancer (NSCLC), particularly regarding survival. We thus characterized the EGFR expression profile, clinical characteristics, and survival outcome in these patients. Patient and Methods: We reviewed the cancer registry and patient charts at a New York-Bronx network (n = 2773) treating a large population of minority patients, for non-squamous NSCLC (n = 1986) diagnosed between 2009 and 2015. Survival was adjusted for smoking, gender, age, weight, and stage. Results: The EGFR mutation rate was 15{\%} (98/652) in tested patients (black, 14{\%}; non-black, 16{\%}). There was no significant difference between the 2 cohorts with respect to age at diagnosis, gender, presenting stages, and socioeconomic status. On the other hand, weight was noted to be heavier in black patients with EGFR-mutated NSCLC than their non-black counterparts (P = .012). After adjusting for gender, age, smoking status, weight, and stage, the multivariate analysis revealed no racial disparity in survival among patients with wild-type EGFR (P = .774); However, among patients with EGFR-mutated NSCLC, black patients had shorter survival in comparison with non-black patients (P = .001), with 2-year survival rates being 33{\%} versus 61{\%}, respectively. Such shorter survival was also observed among EGFR-inhibitor treated patients with common EGFR mutations (P = .040). Conclusions: To our knowledge, this is the first report of inferior survival among black patients with NSCLC with EGFR mutations, relative to non-black patients. The survival disparities suggest the need of more tailored management for this patient population. Non–small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation is a distinct molecular subgroup with effective targeted therapy. In our study of 2773 patients, the survival was similar between races among EGFR wild-type NSCLC; however, black patients with EGFR-mutant NSCLC had inferior survival compared with their non-black counterparts. More tailored management for this population is warranted.",
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AU - Deng, Lei

AU - Ye, K.

AU - Su, Christopher

AU - Sharma, Janaki N.

AU - Yang, Yuanquan

AU - Halmos, Balazs

AU - Perez-Soler, R.

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N2 - Background: Little is known about the difference between black and non-black patients with epidermal growth factor receptor (EGFR)-mutated non–small-cell lung cancer (NSCLC), particularly regarding survival. We thus characterized the EGFR expression profile, clinical characteristics, and survival outcome in these patients. Patient and Methods: We reviewed the cancer registry and patient charts at a New York-Bronx network (n = 2773) treating a large population of minority patients, for non-squamous NSCLC (n = 1986) diagnosed between 2009 and 2015. Survival was adjusted for smoking, gender, age, weight, and stage. Results: The EGFR mutation rate was 15% (98/652) in tested patients (black, 14%; non-black, 16%). There was no significant difference between the 2 cohorts with respect to age at diagnosis, gender, presenting stages, and socioeconomic status. On the other hand, weight was noted to be heavier in black patients with EGFR-mutated NSCLC than their non-black counterparts (P = .012). After adjusting for gender, age, smoking status, weight, and stage, the multivariate analysis revealed no racial disparity in survival among patients with wild-type EGFR (P = .774); However, among patients with EGFR-mutated NSCLC, black patients had shorter survival in comparison with non-black patients (P = .001), with 2-year survival rates being 33% versus 61%, respectively. Such shorter survival was also observed among EGFR-inhibitor treated patients with common EGFR mutations (P = .040). Conclusions: To our knowledge, this is the first report of inferior survival among black patients with NSCLC with EGFR mutations, relative to non-black patients. The survival disparities suggest the need of more tailored management for this patient population. Non–small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation is a distinct molecular subgroup with effective targeted therapy. In our study of 2773 patients, the survival was similar between races among EGFR wild-type NSCLC; however, black patients with EGFR-mutant NSCLC had inferior survival compared with their non-black counterparts. More tailored management for this population is warranted.

AB - Background: Little is known about the difference between black and non-black patients with epidermal growth factor receptor (EGFR)-mutated non–small-cell lung cancer (NSCLC), particularly regarding survival. We thus characterized the EGFR expression profile, clinical characteristics, and survival outcome in these patients. Patient and Methods: We reviewed the cancer registry and patient charts at a New York-Bronx network (n = 2773) treating a large population of minority patients, for non-squamous NSCLC (n = 1986) diagnosed between 2009 and 2015. Survival was adjusted for smoking, gender, age, weight, and stage. Results: The EGFR mutation rate was 15% (98/652) in tested patients (black, 14%; non-black, 16%). There was no significant difference between the 2 cohorts with respect to age at diagnosis, gender, presenting stages, and socioeconomic status. On the other hand, weight was noted to be heavier in black patients with EGFR-mutated NSCLC than their non-black counterparts (P = .012). After adjusting for gender, age, smoking status, weight, and stage, the multivariate analysis revealed no racial disparity in survival among patients with wild-type EGFR (P = .774); However, among patients with EGFR-mutated NSCLC, black patients had shorter survival in comparison with non-black patients (P = .001), with 2-year survival rates being 33% versus 61%, respectively. Such shorter survival was also observed among EGFR-inhibitor treated patients with common EGFR mutations (P = .040). Conclusions: To our knowledge, this is the first report of inferior survival among black patients with NSCLC with EGFR mutations, relative to non-black patients. The survival disparities suggest the need of more tailored management for this patient population. Non–small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation is a distinct molecular subgroup with effective targeted therapy. In our study of 2773 patients, the survival was similar between races among EGFR wild-type NSCLC; however, black patients with EGFR-mutant NSCLC had inferior survival compared with their non-black counterparts. More tailored management for this population is warranted.

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KW - Uncommon EGFR mutations

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