Clinicopathological Characteristics of 11 NSCLC Patients with EGFR-Exon 20 Mutations

Lund‐Iversen, Marius; Kleinberg, Lilach; Fjellbirkeland, Lars; Helland, Åslaug; Brustugun, Odd Terje

doi:10.1097/jto.0b013e3182614a9d

Cited by 53 publications

(44 citation statements)

References 8 publications

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“…Consistent with other studies (Kosaka et al, 2004;Sharma et al, 2007;Rosell et al, 2009;Lund-Iversen et al, 2012), mutations in exon 19 were more common than those in exon 21 in our patients. Interestingly, our exon 19 mutation-positive patients were significantly younger than exon 21 mutation-positive patients as reported by another study (Lund-Iversen et al, 2012). Since mutations in exons 18 and 20 are relatively rare, it is not surprising that we did not find any of our patients with these two mutations because of our small sample size.…”

Section: Discussionsupporting

confidence: 82%

Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancers in a Multiethnic Malaysian Patient Population

Liam

Leow

How

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Section: Discussionsupporting

confidence: 82%

Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancers in a Multiethnic Malaysian Patient Population

Liam

Leow

How

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…A significant association has been identified between EGFR mutations, particularly exon 19 deletions and exon 21 (L858R) and exon 18 mutations, and a sensitivity to TKIs (4,(32)(33)(34). In addition, exon 20 insertion mutations have been hypothesized to be a valuable predictor of resistance to clinically achievable levels of TKIs (35,36). The prevalence of EGFR mutations in Asian populations with an advanced stage of lung adenocarcinoma is up to 51.4% (37).…”

Section: Discussionmentioning

confidence: 99%

Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Wang

Zhang

Han

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to compare pathological diagnoses, as determined by the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) classification, with conventional radiological features. In addition, the present study aimed to evaluate the correlation among clinical characteristics, computed tomography (CT) images and gene mutation status in patients with stage IA adenocarcinoma of the lung. A total of 212 patients with stage IA lung adenocarcinoma were included in the study. The patients were classified into pure ground-glass opacity (pGGO), mixed GGO (mGGO) and solid GGO (sGGO) by CT imaging. Histological subtype was classified according to the IASLC/ATS/ERS classification of lung adenocarcinoma. In addition, epidermal growth factor receptor (EGFR) and Kirsten rat sarcoma (KRAS) mutation assays were performed, and 36.8% of patients (78/212) were determined to have an EGFR mutation, while 8.5% of patients (18/212) were found to have a KRAS mutation. According to the IASLC/ATS/ERS classification, 44 cases were diagnosed as adenocarcinoma in situ (AIS; 20.8%), 62 cases were diagnosed as minimally invasive adenocarcinoma (MIA; 29.2%) and 106 cases were classified as invasive adenocarcinoma (IAC; 50.0%). pGGO image patterns were observed in 39.2% of patients (n=83), while mGGO and sGGO patterns were observed in 28.8% (n=61) and 32.0% (n=68) of patients, respectively. From pGGO to sGGO, cases of AIS and MIA were shown to have a decreasing trend, while IAC cases exhibited an increasing trend (P=0.036). Analysis of the correlation between CT image patterns and gene mutations demonstrated that L858R point mutations, exon 19 deletions and KRAS mutations were more common in lesions with a lower GGO proportion (P=0.029, 0.027 and 0.018, respectively). Therefore, according to the IASLC/ATS/ERS classification, GGO imaging patterns were shown to correlate with subtypes of adenocarcinomas. In addition, EGFR and KRAS mutations were found to be associated with lesions with a low GGO proportion. Therefore, analysis of GGO lesions may offer useful indications of the histological subtype of an adenocarcinoma in patients with stage IA lung adenocarcinoma, and predictive value for EGFR and KRAS mutations.

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“…Patients with exon 20 insertion mutations are also resistant to TKIs. [23][24][25][26] EGFR T790M is a mutation associated with acquired resistance to EGFR TKI therapy and has been reported in approximately 60% of patients with disease progression after initial response to erlotinib, gefitinib, or afatinib. [27][28][29][30][31][32][33][34] Most patients with sensitizing EGFR mutations become resistant to erlotinib, gefitinib, or afatinib after approximately 9 to 13 months of EGFR TKI therapy.…”

Section: Egfr Mutationsmentioning

confidence: 99%

Non–Small Cell Lung Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology

Ettinger¹,

Wood²,

Aisner³

et al. 2017

J Natl Compr Canc Netw

1,060

975

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Clinicopathological Characteristics of 11 NSCLC Patients with EGFR-Exon 20 Mutations

Abstract: Exon 20 mutations seem to confer insensitivity to TKI treatment.

Cited by 53 publications

References 8 publications

Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancers in a Multiethnic Malaysian Patient Population

Epidermal Growth Factor Receptor Mutations in Non-Small Cell Lung Cancers in a Multiethnic Malaysian Patient Population

Impact of the International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification of stage IA adenocarcinoma of the lung: Correlation between computed tomography images and EGFR and KRAS gene mutations

Non–Small Cell Lung Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology

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