Frequent epidermal growth factor receptor gene mutations in malignant pleural effusion of lung adenocarcinoma

Wu, Shang‐Gin; Ch, Gow; Yu, Chong‐Jen; Chang, Yih‐Leong; Ch, Yang; Yc, Hsu; Shih, Jin-Yuan; Lee, Gary; Yang, Ping

doi:10.1183/09031936.00167407

Cited by 107 publications

(124 citation statements)

References 41 publications

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“…Cytology-proven MPEs caused by lung adenocarcinoma were all included and analysed for EGFR mutations. In our previous studies on EGFR mutations, materials from 225 patients were examined [3,4].…”

Section: Patients and Tissue Procurementmentioning

confidence: 99%

mentioning

confidence: 99%

“…Cancer cells in MPEs can be collected via thoracentesis, instead of through other more invasive procedures, such as biopsy or surgery [3]. Testing cancer cells for epidermal growth factor receptor (EGFR) gene (EGFR) mutation status may aid in predicting the response of EGFR-tyrosine kinase inhibitor (TKI) therapy [3]. Our previous reports have demonstrated that direct sequencing using cell-derived RNA from cell pellets of centrifuged MPEs was a sensitive detection method for EGFR mutation, without using the complicated procedures necessary to isolate cancer cells [3,4].…”

mentioning

confidence: 99%

“…Testing cancer cells for epidermal growth factor receptor (EGFR) gene (EGFR) mutation status may aid in predicting the response of EGFR-tyrosine kinase inhibitor (TKI) therapy [3]. Our previous reports have demonstrated that direct sequencing using cell-derived RNA from cell pellets of centrifuged MPEs was a sensitive detection method for EGFR mutation, without using the complicated procedures necessary to isolate cancer cells [3,4]. This is because inflammatory and mesothelial cells within MPEs have considerably lower EGFR expression in comparison with the overexpression of EGFR in nonsmall cell lung cancer (NSCLC) cells [4][5][6].…”

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Survival of lung adenocarcinoma patients with malignant pleural effusion

Tsai

et al. 2012

Eur Respir J

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In the era of targeted therapy, the association between lung adenocarcinoma patient survival and malignant pleural effusions (MPEs) remains unclear. This study investigated the clinical characteristics, survival and epidermal growth factor receptor (EGFR) gene (EGFR) mutation status of lung adenocarcinoma patients with MPE.From June 2005 to December 2010, consecutive pleural effusions were collected prospectively. Patient clinical characteristics, EGFR mutation status, and overall survival were analysed.We collected MPEs from 448 patients in stage IV lung adenocarcinoma at initial diagnosis. Median overall survival for patients with MPEs at initial diagnosis and following disease progression were 14.3 months and 21.4 months, respectively (p50.001). There were 296 (66.1%) patients harbouring EGFR mutations, the mutation rates among patients with an MPE at initial diagnosis and one following disease progression were 68.2% and 56.6%, respectively (p50.044); the L858R mutation rate was also higher among the former (32.6% versus 18.1%; p50.009). Multivariate analysis revealed that patients who: developed MPEs following disease progression, harboured EGFR mutations, and received EGFR-tyrosine kinase inhibitor therapy, had longer overall survival. Patients in stage IV lung adenocarcinoma with MPEs at initial diagnosis have shorter overall survival and higher EGFR mutation rate, especially for L858R, than patients who develop MPEs following disease progression.

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Section: Patients and Tissue Procurementmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Survival of lung adenocarcinoma patients with malignant pleural effusion

Tsai

et al. 2012

Eur Respir J

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“…In our study, the EGFR mutation rate was 70.31%, which was much higher than the above results. Wu et al (48) detected EGFR mutations in surgical resected specimens of lung adenocarcinoma. The results showed that 93 out of 136 patients with MPEs caused by lung adenocarcinoma had positive EGFR mutations.…”

Section: Discussionmentioning

confidence: 99%

EGFR mutations predict a favorable outcome for malignant pleural effusion of lung adenocarcinoma with Tarceva therapy

Guo

Wan²,

Tian³

et al. 2011

Oncol Rep

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Abstract. The aim of the present study was to evaluate the therapeutic effects and adverse reactions of Tarceva treatment for malignant pleural effusion (MPE) caused by metastatic lung adenocarcinomas. One hundred and twenty-eight patients who failed first-line chemotherapy drug treatment were divided into a mutation and a non-mutation group according to the presence or absence of epidermal growth factor receptor (EGFR) mutations. Each patient received closed drainage combined with simple negative pressure suction after thoracoscopic talc poudrage pleurodesis and oral Tarceva treatment. Short-term and long-term clinical therapeutic effects of Tarceva were evaluated. The EGFR mutation rate in pleural metastatic tissues of lung adenocarcinoma acquired through video-assisted thoracoscopic surgery was higher compared to that in surgical resection specimens, plasma specimens and pleural effusion specimens compared to previously reported results. There were significant statistical differences in the average extubation time (p<0.01), drainage volume of pleural effusion (p<0.05), Karnofsky score and formation of encapsulated pleural effusion 4 weeks after surgery (p<0.05) between these two groups. The number of patients with mild pleural hypertrophy in the mutation group was significantly higher compared to the non-mutation group (p<0.01), while the number of patients with severe pleural hypertrophy was significantly reduced (p<0.05). There was significant statistical discrepancy between these two groups in terms of improvement of peripheral blood carcinoembryonic antigen and tissue polypeptide antigen after 4 weeks of therapy. The complete remission rate and the efficacy rate were higher in the mutation group compared to that in the non-mutation group (p<0.05). There was a longer overall survival time after Tarceva treatment in patients with EGFR mutations than those without EGFR mutation. EGFR mutations predict a favorable outcome for malignant pleural effusion of lung adenocarcinoma with Tarceva therapy. Detection of EGFR mutations may determine the responsiveness of malignant pleural effusion to Tarceva treatment.

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Impact of thoracic tumor radiotherapy on survival in non‐small‐cell lung cancer with malignant pleural effusion treated with targeted therapy: Propensity score matching study

Li,

Hu,

et al. 2023

Cancer Medicine

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BackgroundEGFR‐mutant (EGFR‐M) and ALK‐positive (ALK‐P)are common in malignant pleural effusion (MPE) with metastatic non‐small‐cell lung cancer (NSCLC) (MPE‐NSCLC). The impact of thoracic tumor radiotherapy on survival in such patients remains unclear. We aimed to investigate whether thoracic tumor radiotherapy could improve overall survival (OS) in such patients.MethodsAccording to whether or not patients accepted thoracic tumor radiotherapy, 148 patients with EGFR‐M or ALK‐P MPE‐NSCLC treated with targeted therapy were classified into two groups: DT group without thoracic tumor radiotherapy and DRT group with thoracic tumor radiotherapy. Propensity score matching (PSM) was performed to balance clinical baseline characteristics. Overall survival was analyzed by Kaplan–Meier, compared by log‐rank test, and evaluated using Cox proportional hazards model.ResultsMedian survival time (MST) was 25 months versus 17 months in the DRT group and DT group. The OS rates at 1, 2, 3, 5 years in the DRT group and DT group were 75.0%, 52.8%, 26.8%, 11.1% and 64.5%, 28.4%, 9.2%, 1.8%, respectively (χ2 = 12.028, p = 0.001). Compared with DT group, the DRT group still had better survival after PSM (p = 0.007). Before and after PSM, factors associated with better OS through multivariable analysis were that thoracic tumor radiotherapy, radiotherapy, N0‐2, and ALK‐TKIs. Grades 4–5 radiation toxicities were not observed in patients; 8 (11.6%) and 7 (10.1%) out of the DRT group suffered from Grade 3 radiation esophagitis and radiation pneumonitis, respectively.ConclusionOur results for EGFR‐M or ALK‐P MPE‐NSCLC showed that thoracic tumor radiotherapy may be crucial factor in improving OS with acceptable toxicities. Potential biases should not be neglected: Further randomized controlled trials are necessary to confirm this result.

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Frequent epidermal growth factor receptor gene mutations in malignant pleural effusion of lung adenocarcinoma

Cited by 107 publications

References 41 publications

Survival of lung adenocarcinoma patients with malignant pleural effusion

Survival of lung adenocarcinoma patients with malignant pleural effusion

EGFR mutations predict a favorable outcome for malignant pleural effusion of lung adenocarcinoma with Tarceva therapy

Impact of thoracic tumor radiotherapy on survival in non‐small‐cell lung cancer with malignant pleural effusion treated with targeted therapy: Propensity score matching study

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