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K. Okudela
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P1.02 - Poster Session with Presenters Present (ID 454)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Biology/Pathology
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.02-019 - Complex Mutation of Epidermal Growth Factor Receptor (EGFR) in Patients with Non-Small Lung Cancer (ID 4672)
14:30 - 15:45 | Author(s): K. Okudela
- Abstract
Background:
Analysis of the epidermal growth factor receptor (EGFR) gene is currently one of the most important tests in establishment of a treatment strategy for primary lung cancer. Major mutations of exon 19 deletion and exon 20 point mutation (L858R) are particularly well known in adenocarcinomas, and tyrosine kinase inhibitors (TKIs) have provided significant benefits to patients with such mutations. Complex mutation patterns of EGFR have also been reported, but their significance is unknown.
Methods:
Clinicopathological features and response to treatment of non-small lung cancer (NSCLC) with complex mutation of the EGFR gene were investigated in cases treated at Kanagawa Cardiovascular and Respiratory Center from June 2014 to March 2016.
Results:
EGFR gene analysis was performed in 334 cases, of which 108 had EGFR mutations. These cases included 7 (6.5%) with complex mutations: two males (28.6%) and five females (71.4%) with an age of 71.0±6.0 (mean±SD) years. Five of the 7 cases underwent surgery and two were inoperable. The histological diagnoses were adenocarcinomas (n=6) and squamous cell carcinoma (n=1). The pathological stage in the surgical cases (all adenocarcinomas) were IB, IIA, and IIIA in 2, 1 and 2 cases, respectively. Both inoperable cases were clinical stage IV. The EGFR complex mutation patterns were 19 deletion and 20 T790M (n=2, with one case with acquired TKI resistance), 18 G719X and 21 L861Q (n=3), 19 deletion and 21 L858R (n=1), and 20 T790 and 21 L858R (n=1). In the five surgical cases, two (pStage IIA, 19 deletion and 20 T790M; pStage IIIA, 18 G719X and 21 L861Q) received postoperative TKI therapy because of recurrence. Both patients had a poor response to TKIs and both died. The patients in another three surgical cases are alive without receiving TKI therapy. Two inoperable cases (19 deletion and 20 T790M; 18 G719X and 21 L861Q) were treated with standard chemotherapy and TKIs, and also died. The disease-free survival period in the surgical cases was 532±319 days and the overall survival period in the case with postoperative recurrence and the inoperable cases was 810±563 days. The progression-free survival period in patients treated with TKIs was 101.5±90.6 days.
Conclusion:
In patients with EGFR mutation, 6.5% have complex mutations, of which 85.7% are minor-on-minor or minor-on-major mutations. Lung cancer with complex mutation of EGFR tends to have a poorer response to TKIs compared to cases with a major single mutation.
