EGFR mutations in early‐stage and advanced‐stage lung adenocarcinoma: Analysis based on large‐scale data from China

Abstract

BackgroundEGFR‐tyrosine kinase inhibitors play an important role in the treatment of advanced non‐small cell lung cancer (NSCLC). EGFR mutations in advanced NSCLC occur in approximately 35% of Asian patients and 60% of patients with adenocarcinoma. However, the frequency and type of EGFR mutations in early‐stage lung adenocarcinoma remain unclear.MethodsWe retrospectively collected data on patients diagnosed with lung adenocarcinoma tested for EGFR mutation. Early stage was defined as pathological stage IA–IIIA after radical lung cancer surgery, and advanced stage was defined as clinical stage IIIB without the opportunity for curative treatment or stage IV according to the American Joint Committee on Cancer Staging Manual, 7th edition.ResultsA total of 1699 patients were enrolled in this study from May 2014 to May 2016; 750 were assigned to the early‐stage and 949 to the advanced‐stage group. Baseline characteristics of the two groups were balanced, except that there were more smokers in the advanced‐stage group (P < 0.001). The total EGFR mutation rate in the early‐stage group was similar to that in the advanced‐stage group (53.6% vs. 51.4%, respectively; P = 0.379). There was no significant difference in EGFR mutation type between the two groups. In subgroup analysis of smoking history, there was no difference in EGFR mutation frequency or type between the early‐stage and advanced‐stage groups.ConclusionEarly‐stage and advanced‐stage groups exhibited the same EGFR mutation frequencies and types.

Development and validation of a model to predict tyrosine kinase inhibitor‐sensitive EGFR mutations of non‐small cell lung cancer based on multi‐institutional data

“…In Chinese patients, the EGFR mutation rate of AC is approximately 52.4%. 20 By contrast, EGFR mutations are rarely detected in other pathological types of NSCLC, such as squamous cell carcinoma; only 6.9% of patients with squamous cell carcinoma harbor EGFR mutations. 21 Quan et al enrolled 354 Chinese patients with NSCLC and showed higher EGFR mutation rates in women than in men (60.13% vs. 38.81%; P = 0.029).…”

“…The classic factors associated with a higher rate of EGFR activating mutations are AC, female gender, and never smoker status. In Chinese patients, the EGFR mutation rate of AC is approximately 52.4% . By contrast, EGFR mutations are rarely detected in other pathological types of NSCLC, such as squamous cell carcinoma; only 6.9% of patients with squamous cell carcinoma harbor EGFR mutations .…”

CDK4/6 inhibitor palbociclib overcomes acquired resistance to third‐generation EGFR inhibitor osimertinib in non‐small cell lung cancer (NSCLC)

“…1,2 Non-small cell lung cancer (NSCLC) accounts for about 92% of patients with lung cancer 3 and in an Asian population 30%-52.4% of patients with NSCLC had EGFRactivating mutations. [4][5][6] Targeted treatment with tyrosine kinase inhibitors (TKIs) significantly prolonged the progression-free survival (PFS) in patients with EGFR mutations, [7][8][9] which was about 4.6-6.4 months in the era of chemotherapy to 9.8-13.1 months in first-generation TKIs, and then to 18.9 months in the FLAURA study.…”

Role of YES1 amplification in EGFR mutation‐positive non‐small cell lung cancer: Primary resistance to afatinib in a patient

“…Approximately 37.5%–51.4% of Chinese patients with advanced NSCLC have been found to have somatic activating mutations in EGFR 1–3 . Patients with NSCLC who have somatic mutations of the EGFR gene have been found to benefit from EGFR‐TKIs including gefitinib, erlotinib, afatinib, dacomitinib, osimertinib and so on.…”