Frequency and Type of Epidermal Growth Factor Receptor Mutations in Moroccan Patients with Lung Adenocarcinoma

Errihani, Hassan; Inrhaoun, Hanane; Boukir, A.; Kettani, Fouad; Gamra, L.; Mestari, Amina; Jabri, L.; Bensouda, Y.; Mrabti, Hind; Elghissassi, Ibrahim

doi:10.1097/jto.0b013e31829f6b4a

Cited by 35 publications

(52 citation statements)

References 15 publications

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“…[3][4][5] Of note, in our retrospective study that was recently published in this journal, the rate of rare EGFR mutations (exon 20 analysis was also performed) was 10% of all mutations. 6 Finally, we agree with the authors' statement with regard to the fact that some of their results need to be confirmed in a prospective setting because in any retrospective study, some sources of bias cannot be ruled out.…”

supporting

confidence: 76%

The Frequency of Rare EGFR Mutations Is Higher than that of Classical Ones

Elghissassi

Boutayeb

Errihani

2016

Journal of Thoracic Oncology

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Because only a few studies have been published on this topic, we have read with great interest the article of Lohinai et al. titled, "Distinct Epidemiology and Clinical Consequence of Classic versus Rare EGFR Mutations in Lung Adenocarcinoma." 1 The authors compare the epidemiology and clinical consequence of classical and rare epidermal growth factor receptor gene (EGFR) mutations in a cohort of Hungarian patients with lung adenocarcinoma. They defined classical EGFR mutations as the combination of the L858R point mutation in exon 21 and exon 19 microdeletions, rare EGFR mutations as nonclassical mutation in the tyrosine kinase-coding region (exons 18-21) where amino acid change occurs, and synonymous EGFR mutations as nucleotide changes without protein alterations.In their article, Lohinai et al. reported that classical and rare nonsynonymous EGFR mutations were identified in 5% and 6% of patients, respectively. This finding is quite surprising for several reasons. First, the incidence of rare EGFR mutations in this study is much higher than in similar studies of whites (0.8%-4.4%). [2][3][4] Lohinai et al. justified this high rate of rare EGFR mutations by the facts that exon 20 sequencing was also performed in three-fourths of patients and 40% of all patients with Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations underwent EGFR analysis as well. In our opinion, these arguments cannot fully explain the high rate of rare EGFR mutation because most of the recent studies in whites that have reported the frequency of EGFR mutation subtypes have also included exon 20 analysis 2-4 and, on the other hand, only three patients (< 0.4%) with a concomitant KRAS mutation and rare EGFR mutations were found in the present study.Second, the fact that the proportion of rare EGFR mutations is higher than that of classical ones, as found in this series, seems inadequate by definition. Indeed, in studies of both whites and Asians, it has been reported that about 90% of all lung adenocarcinoma-associated EGFR mutations are classical ones whereas the proportion of rare EGFR mutations does not usually exceed 10% to 15%. [3][4][5] Of note, in our retrospective study that was recently published in this journal, the rate of rare EGFR mutations (exon 20 analysis was also performed) was 10% of all mutations. 6 Finally, we agree with the authors' statement with regard to the fact that some of their results need to be confirmed in a prospective setting because in any retrospective study, some sources of bias cannot be ruled out.

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confidence: 76%

The Frequency of Rare EGFR Mutations Is Higher than that of Classical Ones

Elghissassi

Boutayeb

Errihani

2016

Journal of Thoracic Oncology

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“…Other studies from a single institution or country revealed a lower mutation rate, as in a recent study of 137 patients from Morocco, which reported a mutation rate of 20% (10). In another study on 106 Lebanese patients with adenocarcinoma, only 8.5% harbored EGFRmut (11).…”

Section: Discussionmentioning

confidence: 90%

Patterns of epidermal growth factor receptor mutation in non-small-cell lung cancers in the Gulf region

Jazieh

Jaafar

Jaloudi

et al. 2015

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to determine the prevalence of epidermal growth factor receptor mutations (EGFRmut) in the Gulf region (GR) and its correlation with demographic and clinical characteristics. A multisite retrospective study was conducted, including institutions from Saudi Arabia, the United Arab Emirates and Qatar. All consecutive patients with non-small-cell lung cancer tested for EGFRmut were eligible. Data collected included demographic information, disease characteristics and EGFR test results. Data on 230 patients were obtained. The median age of the patients was 61 years (range, 26-87 years); 169 patients (69.83%) were male and 204 (88.7%) were Arab. The histological subtype was adenocarcinoma in 191 (83.4%) and squamous cell carcinoma in 21 cases (9.17%). Overall, EGFRmut were detected in 66 patients (28.7%), with a prevalence of 32.46% in adenocarcinoma. No squamous cell carcinomas were found to harbor EGFRmut. The univariate and multivariate analyses revealed that female gender, non-smoking status and adenocarcinoma subtype were significant predictors for EGFRmut. There was no difference between Arabs and non-Arabs. In conclusion, to the best of our knowledge, this is the first multisite study to report the prevalence of EGFRmut in the GR population, which was found to be higher compared with that in Western, but lower compared with that in Far Eastern populations. Studies evaluating the efficacy of targeted therapy in this population are underway.

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“…A separate study showed EGFR mutation rate was 35% in the Asian race, while non-smoking adenocarcinoma mutation rate was 59%10. In the Monaco race11, lung adenocarcinoma mutation rate was 21% (28/137). In the present study, EGFR mutation rate was 55.4%.…”

Section: Discussionmentioning

confidence: 94%

Efficacy analysis of tyrosine kinase inhibitors on rare non-small cell lung cancer patients harboring complex EGFR mutations

Peng

Song

Jiao

2014

Sci Rep

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The efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI) in patients with non-small cell lung cancer (NSCLC) is related to EGFR mutations. Although the p.L858R point mutation in exon 21 and the in-frame deletion mutation in exon 19 are well known, efficacy of EGFR-TKI in patients with more than one EGFR mutation is not well understood. 799 NSCLC patients were screened for EGFR mutations. Of the 799 patients, 443 (55.4%) had mutations, out of which 22 (2.75%) had multiple complex mutations. Most multiple mutations (20/22) harbored common mutations such as the p.L858R point mutation in exon 21 and the in-frame deletion mutation in exon 19. 11 out of 22 patients who had multiple EGFR mutations underwent TKI therapy and primary end-points of progression free and overall survival were determined. Our analysis revealed that cases with multiple mutations had similar end-point outcomes as single mutation to TKI therapy. Report of these cases will be helpful in decision making for treatment of NSCLC patients harboring multiple EGFR mutations.

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Frequency and Type of Epidermal Growth Factor Receptor Mutations in Moroccan Patients with Lung Adenocarcinoma

Abstract: Some one fifth of lung AC tumors in Moroccan patients harbor EGFR mutations. This mutation frequency is higher than that found in whites but lower than in Asian population. Further studies, in larger numbers of patients, are needed to confirm these findings.

Cited by 35 publications

References 15 publications

The Frequency of Rare EGFR Mutations Is Higher than that of Classical Ones

The Frequency of Rare EGFR Mutations Is Higher than that of Classical Ones

Patterns of epidermal growth factor receptor mutation in non-small-cell lung cancers in the Gulf region

Efficacy analysis of tyrosine kinase inhibitors on rare non-small cell lung cancer patients harboring complex EGFR mutations

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