Reliable prediction of progression patterns and failure sites for patients with stage IV lung adenocarcinoma is valuable for physicians to deliver personalized TKI treatment. Therefore, this study was done to demonstrate progression patterns and failure sites for patients with stage IV lung adenocarcinoma is valuable for physicians to deliver personalized TKI treatment.
266 patients who had stage IV lung adenocarcinoma and received first-line TKI treatment were retrospectively enrolled.
62.4% of the participants developed systemic progression, and 37.6% developed oligoprogression. Both cohorts had a median PFS of 9 months. The percentage of patients who developed original and distant failure was 39.1% and 60.9%, respectively. Patients with oligometastasis at initial diagnosis were more prone to develop oligoprogression, whereas pulmonary metastasis was negatively correlated with oligoprogression. Both oligometastasis diagnosis and the maximum diameter of the primary lung lesion were strong predictive factors for original failures. Osseous metastasis at initial diagnosis might be an indication of distant failure.
The study concluded that over one-half of patients with stage IV lung adenocarcinoma receiving first-line TKI treatment developed systemic progression and distant failure.