Cost-effectiveness of ceritinib in previously untreated ALK-positive advanced non-small cell lung cancer in Hong Kong

Abstract

Background: Epidermal growth factor receptor (EGFR) mutations are potential therapeutic targets leading to improved response and progression free survival with EGFR tyrosine kinase inhibitors in NSCLC. Some studies have demonstrated a genetic divergence of EGFR mutation rates according to ethnicity with highest frequencies reported in Asian populations (47%). In this study, we conducted a systematic review of publications related to the frequency of the EGFR mutation in Middle East and African regions to compare the results with those of asian populations. Methods: We used PubMed and the Cochrane Library databases to conduct a literature search using the terms "[EGFR] AND [mutation] AND [Non Small Cell Lung Cancer] AND [Middle East OR Africa]." We assessed studies published in English and French from 2004 until 2016. Results: Ten relevant studies were included in this systematic review. Overall, 1215 patients with non-small cell lung cancer (NSCLC) were included in this analysis. The overall ratio of male to female patients was 2.15. Of total patients included, 41.1% had never smoked and 85.8% had been diagnosed with adenocarcinoma. In 8 of the 10 studies, polymerase chain reaction (PCR) analyses were conducted to identify EGFR mutations. In total, 257 patients had an EGFR mutation, corresponding to a prevalence of 21.2%. The most frequent abnormality detected in all of the studies was in exon 19. In addition, all studies concluded the presence of a correlation between EGFR mutation status and female sex, non-smoking status, and adenocarcinoma subtype.