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Prevalence and outcome of epidermal growth factor receptor mutations in non-squamous non-small cell lung cancer patients.

Kota R, Gundeti S, Gullipalli M, Linga VG, Maddali LS, Digumarti R - Lung India (2015 Nov-Dec)

Bottom Line: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers.Most common mutations were observed in exons 19 (71%) and 21 (25%).The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.

ABSTRACT

Background: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients as it is now recognized both as a prognostic and predictive marker to therapy with EGFR tyrosine kinase inhibitors (TKI).

Aim: In this retrospective study conducted at a University hospital, we evaluated the prevalence of EGFR mutations in patients with NS-NSCLC, clinico-pathological correlation and outcome to treatment with EGFR TKIs.

Materials and methods: Case records of 147 patients of NS-NSCLC in whom EGFR mutation status was tested were screened. EGFR mutation analysis was done using DNA sequencing by real time polymerase chain reaction method from tissue and cell blocks prepared from core biopsy, fine needle aspiration cytology and pleural fluid specimens.

Results: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers. Most common mutations were observed in exons 19 (71%) and 21 (25%). The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively.

Conclusion: This study from India, further establishes the importance of upfront EGFR mutation testing in all NS-NSCLC patients, not only to prognosticate, but also to identify that subset of patients who could benefit from EGFR TKI therapy, early in the course of their disease.

No MeSH data available.


Related in: MedlinePlus

EGFR mutation status
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Figure 3: EGFR mutation status

Mentions: Out of the 147 samples sent for EGFR mutational analysis, 36 specimens (biopsy specimens - 11 and cell blocks prepared from FNAC and pleural fluid - 20 and 5, respectively) had insufficient tumor tissue for the test to be performed [Figure 2]. Of the evaluable 111 patients, any one of the activating EGFR mutation was detected with a frequency of 30.6% [Figure 3]. The most common EGFR activating mutations observed were in frame deletions in exon 19 (71%) and a missense mutation L858R in exon 21 (25%). Overall the EGFR mutations were significantly higher in females as compared to males (44% vs. 19.6%, Fisher's exact two-tailed test, P = 0.0072). Nonsmokers had significantly higher mutations than smokers (41% vs. 12%, Fisher's exact two-tailed test, P = 0.0013). The EGFR mutations did not correlate with the histology and stage of the disease [Table 2].


Prevalence and outcome of epidermal growth factor receptor mutations in non-squamous non-small cell lung cancer patients.

Kota R, Gundeti S, Gullipalli M, Linga VG, Maddali LS, Digumarti R - Lung India (2015 Nov-Dec)

EGFR mutation status
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663857&req=5

Figure 3: EGFR mutation status
Mentions: Out of the 147 samples sent for EGFR mutational analysis, 36 specimens (biopsy specimens - 11 and cell blocks prepared from FNAC and pleural fluid - 20 and 5, respectively) had insufficient tumor tissue for the test to be performed [Figure 2]. Of the evaluable 111 patients, any one of the activating EGFR mutation was detected with a frequency of 30.6% [Figure 3]. The most common EGFR activating mutations observed were in frame deletions in exon 19 (71%) and a missense mutation L858R in exon 21 (25%). Overall the EGFR mutations were significantly higher in females as compared to males (44% vs. 19.6%, Fisher's exact two-tailed test, P = 0.0072). Nonsmokers had significantly higher mutations than smokers (41% vs. 12%, Fisher's exact two-tailed test, P = 0.0013). The EGFR mutations did not correlate with the histology and stage of the disease [Table 2].

Bottom Line: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers.Most common mutations were observed in exons 19 (71%) and 21 (25%).The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.

ABSTRACT

Background: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients as it is now recognized both as a prognostic and predictive marker to therapy with EGFR tyrosine kinase inhibitors (TKI).

Aim: In this retrospective study conducted at a University hospital, we evaluated the prevalence of EGFR mutations in patients with NS-NSCLC, clinico-pathological correlation and outcome to treatment with EGFR TKIs.

Materials and methods: Case records of 147 patients of NS-NSCLC in whom EGFR mutation status was tested were screened. EGFR mutation analysis was done using DNA sequencing by real time polymerase chain reaction method from tissue and cell blocks prepared from core biopsy, fine needle aspiration cytology and pleural fluid specimens.

Results: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers. Most common mutations were observed in exons 19 (71%) and 21 (25%). The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively.

Conclusion: This study from India, further establishes the importance of upfront EGFR mutation testing in all NS-NSCLC patients, not only to prognosticate, but also to identify that subset of patients who could benefit from EGFR TKI therapy, early in the course of their disease.

No MeSH data available.


Related in: MedlinePlus