Clinical and Pathological Characteristics, Outcome and Mutational Profiles Regarding Non–Small-Cell Lung Cancer Related to Wood-Smoke Exposure

Arrieta, Óscar; Campos‐Parra, Alma D.; Zuloaga, Carlos; Avilés, Alejandro; Sánchez-Reyes, Roberto; Manríquez, María Eugenia Vázquez; Covián-Molina, Emilia; Martínez-Barrera, Luis Manuel; Meneses, Abelardo; Cardona, Andrés Felipe; Borbolla-Escoboza, José R.

doi:10.1097/jto.0b013e3182582a93

Cited by 52 publications

(49 citation statements)

References 32 publications

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“…Interestingly, epidemiological reports have shown a higher EGFR mutation prevalence in our study population (25,26). This can be explained by different exposure factors associated such as wood smoke exposure (27), high prevalence of chronic tuberculosis infection (28) and ethnicity (29). However, despite spectacular initial response to EGFR-TKIs, most patients eventually develop resistance to treatment and, subsequently, radiological and/or clinical progression.…”

Section: Discussionmentioning

confidence: 69%

Characteristics of progression to tyrosine kinase inhibitors predict overall survival in patients with advanced non-small cell lung cancer harboring an EGFR mutation

Barrón

Cardona²,

Corrales³

et al. 2018

J. Thorac. Dis.

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Background: Non-small cell lung cancer (NSCLC) harboring EGFR-sensitizing mutations has a distinct biology and heterogeneous clinical behavior. We evaluated the characteristics to progression such as clinical patterns of progression (dramatic, gradual, and local) with the prognosis of NSCLC patients treated with tyrosine kinase inhibitors (TKIs). Methods: We reviewed 123 advanced-NSCLC patients with an EGFR-sensitizing mutation treated with TKIs (gefitinib, erlotinib and afatinib). We assessed patients according to clinical factors and progression pattern to TKIs at three centers. Results: For all patients, 58.5%, 31.7% and 9.8% harbored exon19 deletion, exon21 L858R mutation and other-sensitivity mutations, respectively. Median progression-free survival (PFS) was 8.8 months (95% CI: 7.9-9.7). Sixty percent of patients were asymptomatic. Dramatic-progression was the most frequent pattern (50.4%), followed by gradual-progression (32.5%), and local-progression (17.1%). Median overall survival (OS) was 23.1 months (95% CI: 17.4-28.9). In the univariate analysis, factors associated to a longer OS included pattern [gradual-progression (32.1), dramatic (19.5) and local (18.8 months), P=0.008], and the time to progression to TKI [>12 months (38.5), 6-12 months (19.1), <6 months (9.6), P<0.001]. Multivariate analysis showed that only time to progression to TKI was independently associated to OS and PFS. Conclusions: Factors at TKI progression associated to a longer OS can define a subset of patients who may benefit from continued TKI therapy, as well as from local-ablative therapy in progression sites, especially in patients without T790M or who lack access to third-generation TKI.

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Section: Discussionmentioning

confidence: 69%

Characteristics of progression to tyrosine kinase inhibitors predict overall survival in patients with advanced non-small cell lung cancer harboring an EGFR mutation

Barrón

Cardona²,

Corrales³

et al. 2018

J. Thorac. Dis.

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“…Even though the explanation for this variability is not well understood, it does occur, and therefore we must identify possible factors that may explain the differences in lung cancer, such as differences in environmental hazards exposure, within the same geographic region or even within the same ethnic group [40]. Interestingly though, certain characteristics remain throughout the population, including a tendency of ALKr patients to be younger, be light smokers and present adenocarcinoma histology, similar to what we previously reported in a Mexican population in 2015.…”

Section: Discussionmentioning

confidence: 99%

Molecular Epidemiology of <b><i>ALK</i></b> Rearrangements in Advanced Lung Adenocarcinoma in Latin America

Arrieta

Cardona²,

Bramuglia

et al. 2018

Oncology

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Objective: Latin American countries are heterogeneous in terms of lung cancer incidence and exposure to potential carcinogens. We evaluated the frequency and clinical characteristics of ALK rearrangements (ALKr) in Latin America. Methods: A total of 5,130 lung cancer patients from 10 Latin American countries were screened for inclusion. ALKr detection was performed by fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) to assess method variability. Demographic and clinicopathologic characteristics were analyzed. Results: Among the 5,130 patients screened, 8.4% (n = 433) had nonevaluable FISH tests. Evaluable FISH analyses revealed positive ALKr in 6.8% (320/4,697) of the study population, which included patients from 9 countries. ALKr distribution for each country was: Mexico 7.6% (79/1,034), Colombia 4.1% (10/242), Argentina 6.0% (153/2,534), Costa Rica 9.5% (13/137), Panama 4.4% (5/114), Uruguay 5.4% (2/37), Chile 8.6% (16/185), Venezuela 8.9% (13/146), and Peru 10.8% (29/268). RT-PCR showed high positive (83.6%) and negative (99.7%) predictive values when compared to the gold standard FISH. In contrast, IHC only showed a high negative predictive value (94.6%). Conclusions: Although there is a clear country and continental variability in terms of ALKr frequency, this difference is not significant and the overall incidence of ALKr in Latin America does not differ from the rest of the world.

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“…The low frequency of tobacco exposure suggests that other risk factors are associated with lung cancer in Mexico. 39 The high prevalence of ALK + patients in our study likely reflects a selection bias (clinically enriched population), and considering this is the first report of ALK prevalence in Latin America, we cannot claim a high prevalence at our institute specially accounting the small sample size.…”

Section: Discussionmentioning

confidence: 58%

“…3,6,14,25,[35][36][37][38][39][40][41][42][43] Some reports suggest that patients with ALK-rearranged NSCLC do not exhibit significant ethnic differences in contrast to NSCLC harboring EGFR mutations. 3,4,6,7,14 Consistent with our findings, ALK-rearranged NSCLC patients are usually young (approximately 50 y of age at diagnosis), show no sex predilection, are most often never/ light smokers, and tumors have adenocarcinoma histology with a mucinous component.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of EML4 - ALK Translocation With FISH, Immunohistochemistry, and Real-time Polymerase Chain Reaction in Patients With Non–Small Cell Lung Cancer

Cruz‐Rico¹,

Avilés‐Salas

Segura-González³

et al. 2017

American Journal of Clinical Oncology

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Clinical and Pathological Characteristics, Outcome and Mutational Profiles Regarding Non–Small-Cell Lung Cancer Related to Wood-Smoke Exposure

Abstract: NSCLC patients who smoked tobacco/cigarettes differed from those having a background of WSE regarding tumor histology, mutation profile, response rate, and OS, indicating that different carcinogenic mechanisms were induced by these two types of smoke exposure.

Cited by 52 publications

References 32 publications

Characteristics of progression to tyrosine kinase inhibitors predict overall survival in patients with advanced non-small cell lung cancer harboring an EGFR mutation

Characteristics of progression to tyrosine kinase inhibitors predict overall survival in patients with advanced non-small cell lung cancer harboring an EGFR mutation

Molecular Epidemiology of <b><i>ALK</i></b> Rearrangements in Advanced Lung Adenocarcinoma in Latin America

Diagnosis of EML4 - ALK Translocation With FISH, Immunohistochemistry, and Real-time Polymerase Chain Reaction in Patients With Non–Small Cell Lung Cancer

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