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M. Jung
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P2.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 207)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.01-020 - Clinical Differences of EGFR Mutations in Exon 19 and 21 in Clinical Course of Non-Small Cell Lung Cancer Patients (ID 1464)
09:30 - 17:00 | Author(s): M. Jung
- Abstract
Background:
In patients with non -small cell lung cancer (NSCLC), mutations in the epidermal growth factor receptor (EGFR) have been associated with sensitivity to EGRF-tyrosin kinase inhibitors (TKIs). However, clinical course of EGFR mutation subtypes are still controvertial. The aim of this study was to analyze clinical features between EGFR mutation exon 19 and 21, including treatment with EGFR-TKIs
Methods:
In patients with NSCLC, EGFR exon 19 deletion mutations and EGFR L858R point mutations were analyzed by DNA sequencing method or pyrosequencing method from paraffin blocks of tissue obtained before treatment. We reviewed clinical characteristics of the patients, retrospectively.
Results:
One hundred and sixty seven patients displayed EGFR mutations in exon 19 and exon 21 from October 2002 to December 2013. 63.6% (n=100) had EGFR 19 deletion, whereas 36.3 % (n=67) had an EGFR L858R mutation. There were no differences in sex, smoking, ECOG status, stages, blood chemistry, tumor marker, and overall survivals (OS) between two groups. Overall survival was similar in both groups. However, OS was longer in non-smoker (p=0.000), female (p=0.007), and age ≥ 65 (p=0.031) only in 19 deletion group. After treatment with gefitinib (n=74), erlotinib (n=31), and afatinib (n=2), patients with EGFR mutations had a median overall survival of 47 month. Among the patients treated with gefitinib or erlotinib, gefitinib treated patients had significantly longer progression free survival (PFS) than erlotinib treated patients in EGFR exon 19 deletions (10.3 versus 5.1 months; p=0.002), but not in exon 21 mutation. The median PFS of the patients with higher body surface area (BSA, ≥1.5 m[2]) was worse than that of those with lower BSA (3.9 vs. 8.9 month; p=0.063) in exon 21 mutation group.
Conclusion:
There are different clinical course between types of EGFR exon 19 and 21 mutations. We need confirmation in a prospective study and have to more elucidation of the biological mechanisms of the differences between the two major EGFR mutations.
