非小細胞肺癌患者における上皮成長因子受容体変異とがん関連血栓症

The purposes of this study were to clarify whether non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) gene mutation have a higher incidence of cancer-associated venous and arterial thrombosis/thromboses (CATs) than EGFR-negative patients, and whether patients who develop CATs have a significantly poorer survival.

The relationship between EGFR mutation and the development of CATs was evaluated retrospectively in 1,891 patients with NSCLC, including 381 who were EGFR-positive. Propensity matching and logistic regression analysis were performed.

Among 1,891 patients with NSCLC, 37 patients (2.0%) developed CATs. After propensity matching, the incidence of CATs was 3.9% in EGFR-positive patients and 0.9% in EGFR-negative patients (p = 0.011). Therefore, the risk of developing CATs was higher in EGFR-positive than EGFR-negative patients. In EGFR-positive patients, the most common time to develop CATs was at the time of lung cancer diagnosis, but there were some patients who developed CATs during second-line treatment or later when EGFR-tyrosine kinase inhibitors were no longer effective. In advanced EGFR-positive patients, there was no significant difference in overall survival depending on the presence or absence of CATs, but the development of CATs impaired the long survival expected in EGFR-positive patients.

EGFR-positive patients are currently treated with tyrosine kinase inhibitors and are expected to have a certain long-term prognosis. However, there is concern that overall survival might be shortened if CATs develop. Therefore, the possibility of developing CATs in EGFR-positive NSCLC patients must be addressed.