Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis

Shruti Kate,1 Anuradha Chougule,2 Amit Joshi,1 Vanita Noronha,1 Vijay Patil,1 Rohit Dusane,3 Leena Solanki,1 Priyanka Tiwrekar,2 Vaishakhi Trivedi,1 Kumar Prabhash1 1Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; 2Department of Molecular Pathology, Tata Memorial...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Kate S, Chougule A, Joshi A, Noronha V, Patil V, Dusane R, Solanki L, Tiwrekar P, Trivedi V, Prabhash K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	Uncommon EGFR mutations Advanced NSCLC Tyrosine Kinase Inhibitors Complex EGFR mutations Dual EGFR mutations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/6599250a6aef4ee196a44c6f318a9543
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6599250a6aef4ee196a44c6f318a9543
record_format	dspace
spelling	oai:doaj.org-article:6599250a6aef4ee196a44c6f318a95432021-12-02T07:31:17ZOutcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis1179-2728https://doaj.org/article/6599250a6aef4ee196a44c6f318a95432019-01-01T00:00:00Zhttps://www.dovepress.com/outcome-of-uncommon-egfr-mutation-positive-newly-diagnosed-advanced-no-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Shruti Kate,1 Anuradha Chougule,2 Amit Joshi,1 Vanita Noronha,1 Vijay Patil,1 Rohit Dusane,3 Leena Solanki,1 Priyanka Tiwrekar,2 Vaishakhi Trivedi,1 Kumar Prabhash1 1Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; 2Department of Molecular Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India; 3Department of Biostatistics, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India Background: The significance of uncommon EGFR mutations in newly diagnosed advanced non-small-cell lung cancer (NSCLC) patients is incompletely known. We aimed to analyze the demographic profile, outcome, and treatment attributes of these patients.Patients and methods: We retrospectively surveyed 5,738 advanced NSCLC patients who underwent EGFR testing in our center from 2013 to 2017 by in-house primer probes on real time PCR platform. Descriptive data were accumulated from electronic medical records. Survival plot was calculated using Kaplan–Meier method and compared between groups using log-rank test.Results: Out of 1,260 EGFR mutation-positive patients, 83 (6.58%) had uncommon mutations in isolation or in various combinations. Uncommon mutations were more frequent in men, never-smokers, and adenocarcinomas. Overall, exon 18 G719X, exon 20 insertion, exon 20 T790M, exon 20 S768I, and exon 21 (L858R/L861Q) were present in 9.6%, 19.3%, 12%, 3.6%, and 3.6% patients, respectively. Dual mutation positivity was found in 50.6% patients. On classifying patients as per tyrosine kinase inhibitor (TKI) sensitivity, it was found that majority of the patients had a combination TKI sensitive and insensitive mutations. The median duration of follow-up was 13 months. Five patients were lost to follow-up. Median progression-free survival on first line therapy was 6.7 months (95% CI: 4.8–8.5). Median overall survival (OS) of patients who received TKI during the course of their disease was 20.2 months (95% CI: 11.4–28.9). Median overall survival (mOS) of the entire cohort was 15.8 months (95% CI: 10.1–21.5). Among all uncommon mutations, patients with dual mutations did better, with an mOS time of 22.6 months (95% CI: 8.2–37.0, P=0.005). It was observed that TKI sensitive/TKI insensitive dual mutations had a superior OS of 28.2 months (95% CI: 15.2–41.2, P=0.039) as compared to TKI sensitive and TKI insensitive EGFR mutations.Conclusion: Uncommon EGFR mutations constitute a heterogeneous group, hence, it is imperative to understand each subgroup more to define optimal treatment. Keywords: uncommon EGFR mutations, advanced NSCLC, tyrosine kinase inhibitors, complex EGFR mutations, dual EGFR mutationsKate SChougule AJoshi ANoronha VPatil VDusane RSolanki LTiwrekar PTrivedi VPrabhash KDove Medical PressarticleUncommon EGFR mutationsAdvanced NSCLCTyrosine Kinase InhibitorsComplex EGFR mutationsDual EGFR mutationsNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 10, Pp 1-10 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Uncommon EGFR mutations Advanced NSCLC Tyrosine Kinase Inhibitors Complex EGFR mutations Dual EGFR mutations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Uncommon EGFR mutations Advanced NSCLC Tyrosine Kinase Inhibitors Complex EGFR mutations Dual EGFR mutations Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Kate S Chougule A Joshi A Noronha V Patil V Dusane R Solanki L Tiwrekar P Trivedi V Prabhash K Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
description	Shruti Kate,1 Anuradha Chougule,2 Amit Joshi,1 Vanita Noronha,1 Vijay Patil,1 Rohit Dusane,3 Leena Solanki,1 Priyanka Tiwrekar,2 Vaishakhi Trivedi,1 Kumar Prabhash1 1Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; 2Department of Molecular Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India; 3Department of Biostatistics, Clinical Research Secretariat, Tata Memorial Hospital, Mumbai, Maharashtra, India Background: The significance of uncommon EGFR mutations in newly diagnosed advanced non-small-cell lung cancer (NSCLC) patients is incompletely known. We aimed to analyze the demographic profile, outcome, and treatment attributes of these patients.Patients and methods: We retrospectively surveyed 5,738 advanced NSCLC patients who underwent EGFR testing in our center from 2013 to 2017 by in-house primer probes on real time PCR platform. Descriptive data were accumulated from electronic medical records. Survival plot was calculated using Kaplan–Meier method and compared between groups using log-rank test.Results: Out of 1,260 EGFR mutation-positive patients, 83 (6.58%) had uncommon mutations in isolation or in various combinations. Uncommon mutations were more frequent in men, never-smokers, and adenocarcinomas. Overall, exon 18 G719X, exon 20 insertion, exon 20 T790M, exon 20 S768I, and exon 21 (L858R/L861Q) were present in 9.6%, 19.3%, 12%, 3.6%, and 3.6% patients, respectively. Dual mutation positivity was found in 50.6% patients. On classifying patients as per tyrosine kinase inhibitor (TKI) sensitivity, it was found that majority of the patients had a combination TKI sensitive and insensitive mutations. The median duration of follow-up was 13 months. Five patients were lost to follow-up. Median progression-free survival on first line therapy was 6.7 months (95% CI: 4.8–8.5). Median overall survival (OS) of patients who received TKI during the course of their disease was 20.2 months (95% CI: 11.4–28.9). Median overall survival (mOS) of the entire cohort was 15.8 months (95% CI: 10.1–21.5). Among all uncommon mutations, patients with dual mutations did better, with an mOS time of 22.6 months (95% CI: 8.2–37.0, P=0.005). It was observed that TKI sensitive/TKI insensitive dual mutations had a superior OS of 28.2 months (95% CI: 15.2–41.2, P=0.039) as compared to TKI sensitive and TKI insensitive EGFR mutations.Conclusion: Uncommon EGFR mutations constitute a heterogeneous group, hence, it is imperative to understand each subgroup more to define optimal treatment. Keywords: uncommon EGFR mutations, advanced NSCLC, tyrosine kinase inhibitors, complex EGFR mutations, dual EGFR mutations
format	article
author	Kate S Chougule A Joshi A Noronha V Patil V Dusane R Solanki L Tiwrekar P Trivedi V Prabhash K
author_facet	Kate S Chougule A Joshi A Noronha V Patil V Dusane R Solanki L Tiwrekar P Trivedi V Prabhash K
author_sort	Kate S
title	Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
title_short	Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
title_full	Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
title_fullStr	Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
title_full_unstemmed	Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
title_sort	outcome of uncommon egfr mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/6599250a6aef4ee196a44c6f318a9543
work_keys_str_mv	AT kates outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT chougulea outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT joshia outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT noronhav outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT patilv outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT dusaner outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT solankil outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT tiwrekarp outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT trivediv outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis AT prabhashk outcomeofuncommonegfrmutationpositivenewlydiagnosedadvancednonsmallcelllungcancerpatientsasinglecenterretrospectiveanalysis
_version_	1718399405754679296

Outcome of uncommon EGFR mutation positive newly diagnosed advanced non-small cell lung cancer patients: a single center retrospective analysis

Ejemplares similares