Clinicopathologic differences between lung cancer with EGFR gene major (exon 19 deletions and exon 21 L858R) and other minor mutations.

Yamane, Yuki; Goto, Kanako; Kenmotsu, Hirotsugu; Ohe, Y.; Ohmatsu, Hironobu; Niho, Seiji; Yoh, Kiyotaka; Ishii, Genichiro; Nagai, Kanji; Nishiwaki, Yumiko

doi:10.1200/jco.2010.28.15_suppl.7544

Cited by 2 publications

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“…In addition, the patients harboring only EGFR mutations other than exon 19 deletion and exon 21 L858R did not respond to gefitinib. ( 32 ) This is consistent with the findings of the current study that found that the proportion of patients harboring sensitive EGFR mutations to the patients harboring any EGFR mutations was significantly higher in adenocarcinoma patients than in non‐adenocarcinoma NSCLC patients. However, there were statistically significant differences in the RR, DCR and PFS between non‐adenocarcinoma NSCLC patients and adenocarcinoma patients, even though the patients who did not have sensitive EGFR mutations were excluded from the analysis.…”

Section: Discussionsupporting

confidence: 92%

“…In addition, the patients harboring only EGFR mutations other than exon 19 deletion and exon 21 L858R did not respond to gefitinib. (32) This is consistent with the findings of the current study that found that the proportion of patients harboring sensitive EGFR mutations to the patients harboring any EGFR mutations was significantly Sensitive mutation was defined as exon 19 deletion, G719X, L858R or L861Q of EGFR. †One patient who had L858R and T790M was excluded.…”

Section: Discussionsupporting

confidence: 81%

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Efficacy of gefitinib for non‐adenocarcinoma non‐small‐cell lung cancer patients harboring epidermal growth factor receptor mutations: A pooled analysis of published reports

et al. 2011

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The efficacy of gefitinib for patients with non-adenocarcinoma non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations is unclear, because only a small percentage of patients enrolled in the clinical trials to evaluate the efficacy of gefitinib for tumors harboring EGFR mutation were nonadenocarcinoma NSCLC. A pooled analysis was conducted to clarify the efficacy of gefitinib for non-adenocarcinoma NSCLC patients harboring EGFR mutations. A systematic search of the PUBMED databases was conducted to identify all clinical reports that contained advanced non-adenocarcinoma NSCLC patients harboring EGFR mutations and treated with gefitinib. The selected patients were advanced non-adenocarcinoma NSCLC patients harboring EGFR mutations who were treated with gefitinib and described in reports containing the data of the histology, status of EGFR mutations and response to gefitinib. This study selected 33 patients from 15 reports. Twenty-seven and three of the 33 patients were squamous cell carcinoma and adenosquamous cell carcinoma, respectively. One patient each had large-cell carcinoma, pleomorphic carcinoma and spindle cell carcinoma. Twenty-one patients (64%) had sensitive EGFR mutations. The response rate (RR), disease control rate (DCR) and median progression-free survival (mPFS) was 27%, 67-70% and 3.0 months, respectively. These factors were statistically significantly inferior in the non-adenocarcinoma NSCLC patients harboring EGFR mutations to adenocarcinoma patients harboring EGFR mutations selected from the same published reports (RR: 27% vs 66%, P = 0.000028; DCR: 67-70% vs 92-93%, P = 0.000014; mPFS: 3.0 vs 9.4 months, P = 0.0001, respectively). Gefitinib is less effective in non-adenocarcinoma NSCLC harboring EGFR mutations than adenocarcinoma harboring EGFR mutations. (Cancer Sci 2011; 102: 1032-1037 G efitinib, one of the epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI), is used for the treatment of non-small-cell lung cancer (NSCLC). Two study groups have demonstrated the presence of EGFR mutations in some NSCLC patients and reported higher response rates (RR) to gefitinib therapy among these patients.(1,2) The deletion of exon 19 and point-mutation of exon 21 from T to G at codon 858 (L858R) are the most frequently encountered EGFR mutations, accounting for 90% of all the cases.(3) Approximately 3% of the mutations occur at codon 719 resulting in the substitution of glycine to cysteine, alanine or serine (G719X). In addition, approximately 3% are in-frame insertion mutations in exon 20.(4) The RR was the highest in patients with exon 19 deletions followed by L858R and G719X (81%, 71% and 56%, respectively).(5) In contrast, there are no reports of a single patient with the exon 20 insertion mutation who responded to EGFR-TKI.(5) Clinical trials were conducted based on these findings, which showed that gefitinib is an effective treatment option for first-line treatment in NSCLC patients harboring sensitive EGFR mutations with median progressio...

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Section: Discussionsupporting

confidence: 92%

“…In addition, the patients harboring only EGFR mutations other than exon 19 deletion and exon 21 L858R did not respond to gefitinib. (32) This is consistent with the findings of the current study that found that the proportion of patients harboring sensitive EGFR mutations to the patients harboring any EGFR mutations was significantly Sensitive mutation was defined as exon 19 deletion, G719X, L858R or L861Q of EGFR. †One patient who had L858R and T790M was excluded.…”

Section: Discussionsupporting

confidence: 81%

Efficacy of gefitinib for non‐adenocarcinoma non‐small‐cell lung cancer patients harboring epidermal growth factor receptor mutations: A pooled analysis of published reports

et al. 2011

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Evaluation of the suitability of bronchofiberscopic cytological samples for detecting epidermal growth factor receptor (EGFR) gene mutations in lung adenocarcinoma

秀吉¹,

巌²,

浩幸³

et al. 2012

J. Jpn. Soc. Clin. Cytol.

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長岡赤十字病院病理部 1) ，同医療技術部 2) 目的：肺腺癌の EGFR 遺伝子変異解析における気管支鏡下採取細胞診 (BFC：Bronchofiberscopic cytology) 検体の有用性を評価するため，同一症例の BFC 検体と癌組織ホルマリン固定パラフィン切片(FFPES： formalin-fixed paraffin-embedded section)の変異結果の相関性について検討した．方法：119 例の腫瘍 FFPES と同一症例の BFC 検体を対象に検索した．BFC 検体は，97 例が術前の新鮮 BFC 検体であり，22 例は細胞診断用の保存パパニコロウ染色 BFC 標本を検討した．exon19 の欠失変異は Mutant-enriched PCR 法，点突然変異(G719S，G719C，L858R，L861Q)は nested Cycleave 法により解析した(検出感度 0.2％) ．成績：FFPES の EGFR 遺伝子変異結果に対し，BFC 検体の感度と特異度は，それぞれ 96.6％(57/59) ， 100％(60/60)であった．BFC 検体では偽陽性症例はなかったが，偽陰性が 2 例存在し，いずれも細胞診断用 BFC 標本における癌細胞数は 0.2％未満であった．

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Clinicopathologic differences between lung cancer with EGFR gene major (exon 19 deletions and exon 21 L858R) and other minor mutations.

Cited by 2 publications

References 0 publications

Efficacy of gefitinib for non‐adenocarcinoma non‐small‐cell lung cancer patients harboring epidermal growth factor receptor mutations: A pooled analysis of published reports

Efficacy of gefitinib for non‐adenocarcinoma non‐small‐cell lung cancer patients harboring epidermal growth factor receptor mutations: A pooled analysis of published reports

Evaluation of the suitability of bronchofiberscopic cytological samples for detecting epidermal growth factor receptor (EGFR) gene mutations in lung adenocarcinoma

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