The following is a summary of “Radiological characteristics, tertiary lymphoid structures, and survival status associated with EGFR mutation in patients with subsolid nodules like stage I-II LUAD,” published in the March 2024 issue of Oncology by Xie et al.
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are not routinely recommended for patients with subsolid nodules in early-stage lung cancer. However, understanding their clinical value and impact on survival outcomes in patients with EGFR mutation is crucial for determining the appropriateness of EGFR-TKI application in early-stage lung adenocarcinoma (LUAD) presenting as subsolid nodules. In this study, the researchers included patients with clinical staging of IA-IIB subsolid nodules and recorded clinical information, computed tomography (CT) features, and pathological characteristics, including tertiary lymphoid structures (TLS) of the tumors, to explore their correlation with EGFR mutation and prognosis. A total of 325 patients were enrolled, with 53.2% harboring EGFR mutation. Logistic regression analysis revealed that female gender, mixed ground glass nodules, and bubble-like lucency were significant risk factors for EGFR mutations. Additionally, EGFR mutations were negatively correlated with TLS presence and density.
Prognosis analysis showed that TLS was associated with better recurrence-free survival (RFS), while EGFR mutations were associated with worse RFS. Furthermore, RFS in patients with TLS significantly exceeded those without TLS within the EGFR wild-type group. Multivariate analyses confirmed that EGFR mutation was an independent prognostic predictor for RFS. These findings suggest that subsolid nodules with EGFR mutation exhibit specific clinical and radiological characteristics associated with worse survival outcomes. Moreover, the negative correlation between EGFR mutation and TLS presence may attenuate the positive impact of TLS on prognosis. Therefore, careful consideration is warranted regarding EGFR-TKIs for further treatment in early LUAD patients with EGFR mutation.
Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-12136-6