Frequency and clinical relevance of EGFR mutations and EML4–ALK translocations in octogenarians with non-small cell lung cancer

Figures & data

Table 1 Characteristics of elderly lung cancer patients in cohort 1 and cohort 2

Characteristics	Elderly patients (>70 years)	Cohort 1			Cohort 2
		Patients 70–74 years of age at the time of first diagnosis	Patients 75–79 years of age at the time of first diagnosis	Patients 80 years of age or older at the time of first diagnosis	Patients 80 years of age or older at the time of first diagnosis
Total, n (%)	75 (100)	33 (44)	26 (35)	16 (21)	32 (100)
Gender, n (%)
Male	48 (64)	18 (55)	19 (73)	11 (69)	14 (44)
Female	27 (36)	15 (45)	7 (27)	5 (31)	18 (56)
Mean age at first diagnosis (years)	76.3	71.9	76.7	84.4	82.9
Patients with non-squamous NSCLC tested for EGFR and ALK, n	45	22	15	8	10
EGFR positive, n (%)	13 (29)	6 (27)	4 (27)	3 (38)	3 (30)
ALK positive, n (%)	3 (6)	0	0	3 (38)	1 (10)

Abbreviation: NSCLC, non-small cell lung cancer.

Figure 1 Smoking history of elderly patients with lung cancer.

Notes: Very elderly patients with lung cancer reported less smoking than did younger seniors with lung cancer. Linear regression was used to describe the association between age and smoking. Slope is −1.4±0.55 (95% CI −2.5 to −0.32, p=0.0120 for nonzero slope).
Abbreviation: PY, pack-years.

Table 2 Smoking and histology data for cohort 1 and cohort 2 (pooled)

Characteristics	All elderly patients (>70 years)	Patients 70–74 years of age at the time of first diagnosis	Patients 75–79 years of age at the time of first diagnosis	Patients 80 years of age or older at the time of first diagnosis
Smoking history, n	107	33	26	48
Never smoker	16	3 (9%)	4 (15%)	9 (19%)
Ex-smoker	41	14 (42%)	11 (42%)	16 (33%)
Active smoker	18	10 (30%)	4 (15%)	4 (8%)
Unknown	32	6 (18%)	7 (27%)	19 (40%)
Average PY	32.2	40.3	34.3	27.5
Histology, n (%)
Adenocarcinoma	50	19 (57)	13 (50)	18 (38)
Other non-squamous NSCLC	9	3 (9)	3 (12)	3 (6)
Squamous cell carcinoma	29	4 (12)	8 (31)	17 (35)
SCLC	13	6 (18)	0	7 (15)
Others	6	1 (3)	2 (8)	3 (6)

Abbreviations: NSCLC, non-small cell lung cancer; PY, pack-years; SCLC, small cell lung cancer.

Table 3 Molecular biology, treatment and patient characteristics for octogenarians with driver alterations

Patient	Gender	Smoking history (PY)	Age at first diagnosis (years)	Stage at first diagnosis (UICC TNM 7)	Driver alteration	Initial treatment	First TKI	Best response to first TKI	Progression-free survival on first TKI (months)	T790M at progression?	Second TKI	Best response to second TKI	Progression-free survival on second TKI (months)	Alive at 12 months/24 months after first diagnosis
1	Female	0	91	IV	EML4–ALK translocation	Crizotinib	Crizotinib	PR	>15	–	–	–	–	Yes/not reached
2	Male	30	88	IV	EML4–ALK translocation	Pemetrexed	Crizotinib	PR	>19	–	–	–	–	Yes/yes
3	Male	ND	84	Ia	EGFR Del 19 mutation	Surgery	None	–	–	–	–	–	–	–
4	Male	5	80	IV	EML4–ALK translocation	Crizotinib	Crizotinib	ND	1	–	–	–	–	No/no
5	Female	0	84	IV	EGFR L858R exon 21 mutation	Afatinib	Afatinib	PR	12	Yes	Osimertinib	PR	>12 months	Yes/yes
6	Male	0	85	IIIB	EGFR exon 19 c.2198C>T, p.(P733L) mutation	Afatinib	Afatinib	SD	6	No	–	–	–	No/no
7	Female	0	95	IV	EGFR Del 19 mutation	Gefitinib	Gefitinib	PR	12	Not tested	–	–	–	Yes/no
8	Female	0	86	IV	EML4–ALK translocation	Crizotinib	Crizotinib	PR	>26	–	–	–	–	Yes/yes
9	Female	0	80	IV	EGFR exon 19 (c.2071C>T, P691S mutation	Erlotinib	Erlotinib	PR	18	Yes	Osimertinib	PR	>15 months	Yes/yes
10	Male	ND	84	Ia	Exon 21 mutation c.2508C>T, p.(R836R)	Surgery	None	–	–	–	–	–	–	–

Abbreviations: PY, pack-years; TKI, tyrosine kinase inhibitor; ND, not documented; SD, stable disease; PR, partial response; UICC, The Union for International Cancer Control; TNM, Tumor, Lymph-node, Metastasis.

Figure 2 PFS of octogenarians treated with an EGFR or ALK TKI.

Abbreviations: Nr, number; PFS, progression-free survival; TKI, tyrosine kinase inhibitor.