Association Between Age at Diagnosis and the Presence of EGFR Mutations in Female Patients with Resected Non-small Cell Lung Cancer

Abstract

Background: Our previous report showed an association between age and outcome in gefitinib-treated female patients with non-small cell lung cancer (NSCLC). Only limited numbers of molecular studies have been performed with respect to the presence of epidermal growth factor receptor (EGFR) mutations according to age. This retrospective study was performed to evaluate a possible association between age at the time diagnosis and the presence of EGFR mutations in female patients with NSCLC. Methods: Tumor specimens were collected retrospectively from paraffin blocks of 98 female patients with primary NSCLC who underwent surgical resection between January 1992 and December 2002 at the Korea Cancer Center Hospital. To detect EGFR mutations, a Scorpion Amplified Refractory Mutation System was used. Results: Most of the study population comprised never smokers (84%) and patients with adenocarcinoma (82%). The age at the time of diagnosis ranged from 34 to 74 years (median, 57 years). When the median age was used as a cutoff value, older patients were more likely to have EGFR mutations than younger patients (70 versus 39%; p ϭ 0.004). After controlling for the effects of histology, smoking history, and stage, age remained a significant predictor for EGFR mutations (odds ratio, 4.03; 95% confidence interval, 1.61-10.09; p ϭ 0.003). Conclusions: Our data suggest that age at the time of diagnosis in female patients with NSCLC may be associated with the frequency of EGFR mutations, a strong indicator for favorable outcomes.

Epidermal growth factor receptor gene mutations in patients with lung adenocarcinoma differ by frequency and type between Uighur and Han ethnic groups in Xinjiang Autonomous Region

“…EGFR mutations are common in older, female, non-smoking patients with well-differentiated tumors (especially bronchioloalveolar carcinoma) [12,17,18]. Our study’s findings are in accordance with these reports in the Han group: EGFR mutation associated with sex, smoking history, and the degree of tumor differentiation.…”

“…Research shows that tumor response to erlotinib is greater in patients with exon 19 mutation compared with patients with exon 21 mutation [18]. In our study, the Uighur group’s mutation rate in exon 19 was higher than that in exon 21 (66.7% vs 33.3%), which is similar to Caucasian population [18].…”

“…In our study, the Uighur group’s mutation rate in exon 19 was higher than that in exon 21 (66.7% vs 33.3%), which is similar to Caucasian population [18]. The Han patients, however, had a slightly lower percentage of exon 19 mutations than exon 21 mutations (44.7% vs. 51.1%).…”

Epidermal growth factor receptor mutations in female patients with postoperative recurrent non-small-cell lung cancer

“…[17,19] Although statistical difference could not be reached with a limited sample size of non-adenocarcinoma and smokers, it appears that a relationship between smoking history and mutational status is not prominent in Asian female patients, [17,31,32] indicating their unique characteristics compared with Western patients.…”

“…[10,11] In particular, molecular data have shown that female patients are associated with a high incidence of epidermal growth factor receptor (EGFR) mutation. [12] According to Eastern studies, [13][14][15][16][17] Asian female NSCLC patients are predominantly never-smokers and are likely to have adenocarcinoma histology. Molecular studies have also reported that Eastern ethnicity is associated with a high incidence of EGFR mutation, [18] a factor that strongly predicts outcomes after treatment with tyrosine kinase inhibitors (TKIs) such as gefitinib or erlotinib.…”