A study of therapy targeted EGFR/ALK mutations in Indian patients with lung adenocarcinoma: A clinical and epidemiological study

Rana, Vandana; Ranjan, Priya; Jagani, Rajat; Rathi, KR; Kumar, Dharmesh; Khera, Anurag

doi:10.1016/j.mjafi.2017.09.005

Cited by 14 publications

(4 citation statements)

References 28 publications

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“…[ 44 45 46 47 48 49 50 51 52 53 ] However, the ALK positivity rate of 11.5% observed in our study is higher than most previous reports (5% in Western and 1.45%–7.6% in Indian individuals). [ 53 54 55 ] Whether this observation represents a true high prevalence of ALK rearrangements in this geographical region remains unknown yet, and more population-based data is required before we can draw definite conclusions.…”

Section: Discussionmentioning

confidence: 97%

Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center

et al. 2020

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Introduction: Over the past few years, the demographic profile of lung cancer has changed. However, most reports are limited by small numbers, short follow-up period, and show an inconsistent pattern. A comprehensive evaluation of changing trends over a long period has not been done. Materials and Methods: Consecutive lung cancer patients were studied over a 10-year period from January 2008 to March 2018 at the All India Institute of Medical Sciences, New Delhi, and relevant clinical information, and survival outcomes were analyzed. Results: A total of 1862 patients were evaluated, with mean (SD) age of 59 (11.1) years, and comprising 82.9% males. Majority were smokers (76.2%) with median smoking index of 500 (interquartile range [IQR]: 300–800). Adenocarcinoma (ADC) was the most common type (34%), followed by squamous cell carcinoma (SCC – 28.6%) and small cell lung cancer (SCLC) (16.1%). Over the 10-year period, ADC increased from 9.5% to 35.9%, SCC from 25.4% to 30.6%, and non-small cell lung cancer -not otherwise specified (NSCLC-NOS) decreased from 49.2% to 21.4%. The proportion of females with lung cancer increased although smoking rates remained similar. Majority of NSCLC (95%) continued to be diagnosed at an advanced stage (3 or 4). Epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements were present in 25.3% and 11.5% ADC patients, respectively. The median overall survival was 8.8 months (IQR 3.7–19) for all patients and 12.57 (IQR 6.2–28.7) months among the 1013 patients who were initiated on specific treatment (chemotherapy, targeted therapy, radiotherapy, or surgery). Never-smokers were younger, more likely to be female and educated, had a higher prevalence of ADC and EGFR/ALK mutations, and had better survival. Conclusion: Among this large cohort, our center seems to follow the global trend with increasing incidence of ADC. EGFR mutation positivity was similar to existing reports, while higher ALK positivity was detected. A characteristic phenotype of never-smokers with lung cancer was elucidated which demonstrated better survival.

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Section: Discussionmentioning

confidence: 97%

Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center

et al. 2020

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“…16 The higher incidence of EGFR mutations in Indians than that in whites could be a possible explanation for this phenomenon. 29 Patients with metastatic disease had a median OS of 7.7 months, which was slightly higher than that in the published literature.…”

Section: Discussionmentioning

confidence: 66%

Palliative chemotherapy with or without cetuximab in recurrent or metastatic squamous cell carcinoma of the head and neck: Indian tertiary care retrospective analysis

et al. 2020

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Background: We report our experience with Indian patients who received palliative chemotherapy with/without cetuximab for recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Methods: Data from 229 R/M SCCHN patients treated with cetuximab and chemotherapy (n = 140) or chemotherapy alone (n = 89) were retrospectively analyzed for response rate (RR), progression-free survival (PFS), overall survival (OS), and safety.Results: Patients receiving cetuximab with chemotherapy demonstrated significant increase in RR (77.1% vs 44.9%, P = .0001), PFS (8.1 vs 6.1 months, P = .039), and OS (11.8 vs 8.0 months, P = .002) compared with patients receiving chemotherapy alone. Continuing cetuximab and changing chemotherapy combination (second line and beyond) in fit patients doubled OS (13.5 vs 6.1 months, P = .001). Adverse effects, except skin reactions (more in the cetuximab with chemotherapy group; P = .001), were similar in both groups.Conclusion: Adding cetuximab to chemotherapy improved ORR, PFS, and OS in Indian R/M SCCHN patients, and cetuximab was well tolerated.cetuximab, head and neck cancer, metastatic disease, palliative, recurrent disease Meetings at which the manuscript was

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“…ALK frequency is reported between 1 to 10% around the world (Fernandez-Bussy et al, 2016;Lee et al, 2018;Maturu et al, 2016;Martin et al, 2016;Tian, 2017;Ramadhan, 2021). Indian data reported a frequency in the range of 4 to 11.5% (Bal et al, 2016;Rana et al, 2018;Mohan et al, 2020;Kishore RR and Pan V, 2023). The method used for ALK detection in these studies was immunohistochemistry or FISH or both.…”

Section: Discussionmentioning

confidence: 96%

Non-Small Cell Lung Cancer: Targetable Variants in Concurrent Tissue and Liquid Biopsy Testing in a North Indian Cohort

Paturu,

Lingaiah,

Kumari

et al. 2023

Asian Pac J Cancer Prev

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Objectives: Testing for EGFR, ALK, ROS1 and MET alterations in paired tissue and plasma samples of treatment-naïve patients of NSCLC and correlating their status with overall survival. Materials and methods: One hundred treatment-naïve patients were recruited after obtaining informed consent. Ten ml of blood was collected within a period of two weeks from histological diagnosis, prior to the start of any treatment. DNA & RNA extraction was done from formalin-fixed paraffin embedded (FFPE) tissue and total cell-free nucleic acid extraction was done from plasma samples. EGFR mutation, ALK, ROS1 and MET rearrangements were tested by ARMS (Amplification Refractory Mutation System) PCR. All statistical analyses were conducted in R version 4.1.1. Results: A total of 61 cases showed molecular alterations in tissue samples which included EGFR mutations (47), ALK rearrangements (12), ROS1 fusion (2). MET alteration was not detected. Forty-three cases showed EGFR mutations in plasma, 26 of which were concurrently positive in tissue. Concordance observed was 62%. ALK-EML4 rearrangement, ROS1 fusion and MET were not detected in plasma samples. Sensitivity and specificity for detection of EGFR mutation in plasma were 55.3% and 67.9% respectively. Univariate Cox regression analysis showed a positive association between EGFR mutation in tissue and overall survival (HR = 0.4; 95% CI: 0.2-0.7; p = 0.003) and improved overall survival in those who received targeted therapy (HR = 0.29; 95% CI: 0.1–0.8; p = 0.02). Conclusion: Concurrent testing in tissue and liquid biopsy in NSCLC increased the detection of EGFR mutations (47% to 64%). This has substantial implications in deciding treatment and administration targeted therapy and the consequent overall survival.

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A study of therapy targeted EGFR/ALK mutations in Indian patients with lung adenocarcinoma: A clinical and epidemiological study

Cited by 14 publications

References 28 publications

Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center

Clinical profile of lung cancer in North India: A 10-year analysis of 1862 patients from a tertiary care center

Palliative chemotherapy with or without cetuximab in recurrent or metastatic squamous cell carcinoma of the head and neck: Indian tertiary care retrospective analysis

Non-Small Cell Lung Cancer: Targetable Variants in Concurrent Tissue and Liquid Biopsy Testing in a North Indian Cohort

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