Certain baseline characteristics appear to show greater epidermal growth factor receptor (EGFR) mutations in patients with advanced non-small-cell lung cancer (NSCLC), according to a recent study published online in the journal Cancer Epidemiology, Biomarkers and Prevention.

The REASON trial, an observational, non-interventional multicenter study, evaluated Caucasian patients with advanced NSCLC in Germany.

A total of 4,196 patients met the inclusion criteria: age greater than or equal to 18, stage IIIb/IV NSCLC, EGFR mutation testing and first-line systemic treatment candidates, and surgery or radiotherapy ineligible patients.


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The primary endpoint was the correlation of mutation status with baseline characteristics, with first-line treatment decision as the secondary endpoint.

Results showed that of 431 patients who had EGFR mutations, females (OR= 1.85; 95% CI: 1.48, 2.32) with adenocarcinoma (OR= 2.94; 95% CI: 2.17, 4.08) who had never smoked (OR= 3.64; 95% CI: 2.91, 4.56) showed correlation with EGFR mutation status (P <0.0001).

The most common first-line systemic treatments used were combination chemotherapy in EGFR mutation-negative NSCLC (78.5%), and EGFR-TKIs in EGFR mutation-positive NSCLC (56.6%).

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The findings suggest that in Caucasian patients who are females with adenocarcinoma histology, and non-smokers showed more likelihood of having EGFR mutations.

The study further proposed that these findings ultimately could help clinical decisions in advanced NSCLC by understanding its prognostic and predictive factors.

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