Recently, prognosis in patients with advanced NSCLC will improve much better than before. In these patients, several patients survive with tumor-bearing state for 5 years or more.Purpose
We retrospectively examined clinical features in patients with advanced NSCLC who survived for 5 years or more.Patients and methods
We extracted 5 years or more survival patients from those who met the following criteria: those with histologically proven NSCLC; those who received first-line chemotherapy between 1 January 2004 and 31 January 2007; those who had advanced stages including stage IIIB (unsuitable for surgical treatment or radical thoracic radiation therapy), stage IV and post-surgical recurrence; and those who had measurable or evaluable lesions. Perioperative chemotherapy was not counted as first-line chemotherapy. The survival time was defined as the time from the initiation date of first-line chemotherapy to the date of death or last follow-up. The survival time data were updated on 31 January 2012. We collected various data from their clinical records as follows: baseline demographics information including sex, PS, stage and histology; chemotherapy including regimen and number of cycles and dose; EGFR genetic-testing.Results
A total of 228 patients met the above criteria. The median survival time was 12.9 months. Seventeen (7.4%) patients—8 males and 9 females, with a median age of 66 (range: 52–80)—survived for 5 years or more. Among these, six had a performance status (PS) of 0 and 11 had a PS of 1; all had adenocarcinoma; 12 had never smoked and 5 were current smokers. Eight patients had stage IV, 6 had relapsed after surgery and 3 had stage IIIB with malignant pleural effusion. Twelve patients underwent EGFR testing: three had exon 19 deletions, two had L858R mutations, two had other mutations and five had the wild type. These 17 survivors may be categorized into four types: (a) patients (n = 4) who responded to EGFR-TKIs only; (b) those (n = 3) who responded to two or more regimens, including EGFR-TKIs; (c) those (n = 7) who responded to one or more regimens but not EGFR-TKIs; and (d) those (n = 3) who had very slow-growing lung cancers.Conclusion
Most patients who survived for 5 years or more responded to one or more regimens for a long period.