Treatment of Patients With Non-small-cell Lung Cancer With UncommonEGFRMutations in Clinical Practice

Abstract

Background/Aim: To describe real clinical outcomes in patients with non-small cell lung cancer who have uncommon epidermal growth factor receptor (EGFR) mutations. Materials and Methods: We performed a retrospective chart review from 15 medical institutes that cover a population of three million people from April 2008 to March 2019. Results: There were 102 patients with uncommon EGFR mutation. Progression-free survival (PFS) tended to be longer in patients receiving afatinib compared with first-generation EGFR tyrosine kinase inhibitors. PFS in patients treated with afatinib or osimertinib was significantly longer than in patients treated with gefitinib or erlotinib (p=0.030). Multivariate analysis also revealed the contribution of afatinib or osimertinib to increased survival. In patients with exon 20 insertions, chemotherapy was efficacious. Conclusion: In treating patients with uncommon EGFR mutations, our results indicate longer-term survival might be achieved with second-generation or later TKIs and cytotoxic chemotherapeutic drugs.The treatment of patients with advanced non-small-cell lung cancer (NSCLC) harboring mutant epidermal growth factor receptor (EGFR) has been revolutionized by the development of EGFR tyrosine kinase inhibitors (TKIs) (1-3). The most common types of EGFR mutation are exon 19 deletions and 5757

Effects of Afatinib on Development of Non-Small-Cell Lung Cancer by Regulating Activity of Wnt/β-Catenin Signaling Pathway

“…The current inhibitor of EGFR mutations in NSCLC has emerged as one of the most common treatments for advanced or metastatic NSCLC [24]. Moreover, Afatinib-treated patients have been shown to have a prolonged PFS [25], which was consistent with our conclusion.…”

Dacomitinib for Advanced Non-small Cell Lung Cancer Patients Harboring Major Uncommon EGFR Alterations: A Dual-Center, Single-Arm, Ambispective Cohort Study in China

“…The current study involved a higher proportion of females and never smokers, and this trend is similar to that seen in patients harboring common mutations. This is in contrast to previous studies on uncommon EGFR mutations ( Wang et al, 2013 ; Chiu et al, 2015a ; Tu et al, 2017 ; Yamada et al, 2020 ). For specific mutation subtypes, G719X (40.6%) and L861Q (21.9%) were the two most frequent single uncommon mutations.…”

“…For specific mutation subtypes, G719X (40.6%) and L861Q (21.9%) were the two most frequent single uncommon mutations. Overall, 34.4% of patients (11/32) had compound mutations, and G719X + S768I was the most common compound mutation (81.8%, 9/11), consistent with the mutation profiles reported by Yamada et al ( Yamada et al, 2020 ) and by Brindel et al ( Brindel et al, 2020 ).…”

“…Patients with compound uncommon mutations have better tumor response and prognosis than patients with single uncommon mutations ( Brindel et al, 2020 ; Yamada et al, 2020 ; Yang et al, 2020 ; Passaro et al, 2021 ; Tan et al, 2021 ). In the study by Yang et al, afatinib yielded better anti-tumor activity against compound uncommon mutations than against major uncommon mutations in both TKI-naïve patients and TKI-pretreated patients ( Yang et al, 2020 ).…”

A long-term responding epidermal growth factor receptor mutated non-small cell lung cancer patient with extremely high mutation allele frequency

“…Epidermal growth factor receptor (EGFR) mutation is the most frequent oncogenic driver in non-small cell lung cancer (NSCLC) [ 1 , 2 ]. Among EGFR mutations, exon 19 deletion and exon 21 L858R are two of the most common mutations; hence they are referred to as common mutations [ 1 ].…”