Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status.
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Date
2013-04
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Abstract
INTRODUCTION: We performed retrospective analysis of 106 patients with lung cancer for which formalin‑fixed
paraffin‑embedded tissues was available. Their epidermal growth factor receptor (EGFR) mutation status and treatment
outcomes are described. MATERIALS AND METHODS: All patients with confirmed non–small cell lung cancer (NSCLC)
during Jan 2008 to Dec 2010 were included. EGFR sequencing was performed with ABI PRISM 310 genetic analyzer.
RESULTS: Forty‑two (39.6%) patients had mutation in one of the four exons characterized. Patients whose EGFR mutational
status was not available at presentation before the start of treatment were started on chemotherapy, n = 46 (43.39%). If
EGFR mutational analysis was available and mutations were present, the patients were started on either upfront tyrosine
kinase inhibitor (TKI), n = 15 (14.15%) or if on chemotherapy arm were allowed to finish six cycles and then start with
maintenance TKIs, n = 26 (24.52%). The median progression free survival for patients with and without mutations was
11 months (95% CI,7-14) and 9 months (95% CI,7-10) respectively. A median PFS of 14 months (95%CI, 12-16) was
seen in the mutation‑positive group that received both chemotherapy followed by switch maintenance with TKIs versus
8 months (95%CI, 7-8 months) in the group that received only TKI. CONCLUSION: The prevalence of EGFR mutations
in this population of NSCLC patients was 39.6% with exon 19 mutation being the most common. The observed benefit
of addition of chemotherapy over TKI in EGFR mutation‑positive group raises the question, can we offer the therapy of
chemotherapy–TKI combination to EGFR mutation‑positive lung cancer patients as shown in the present study.
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Keywords
Chemotherapy, epidermal growth factor receptor, lung, tyrosine kinase inhibitors
Citation
Bhatt A D, Pai R, Rebekah G, Nehru G Arun, Dhananjayan S, Samuel A, Singh A, Joel A, Korula A, Chacko R T. Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status. Indian Journal of Cancer. 2013 Apr-June; 50(2): 94-101.