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Clinical significance of EGFR mutation types in lung adenocarcinoma: A multi-centre Korean study

Title
Clinical significance of EGFR mutation types in lung adenocarcinoma: A multi-centre Korean study
Authors
Yoon, Hee-YoungRyu, Jeong-SeonSim, Yun SuKim, DojinLee, Sung YongChoi, JuwhanPark, SojungRyu, Yon JuLee, Jin HwaChang, Jung Hyun
Ewha Authors
장중현이진화류연주박소정윤희영
SCOPUS Author ID
장중현scopus; 이진화scopus; 류연주scopus
Issue Date
2020
Journal Title
PLOS ONE
ISSN
1932-6203JCR Link
Citation
PLOS ONE vol. 15, no. 2
Publisher
PUBLIC LIBRARY SCIENCE
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Adenocarcinoma is the most common type of non-small cell lung cancer. Some causative genomic alterations in epidermal growth factor receptor (EGFR), including deletions in exon 19 (E19 dels) and a point mutation in E21, are known to have favourable prognoses due to sensitivity to tyrosine kinase inhibitors; however, the prognoses of other uncommon mutations are unclear. This study analysed the clinical significance of EGFR mutation types in lung adenocarcinoma. We retrospectively reviewed 1,020 subjects (mean age: 66.8 years, female: 41.7%) who were diagnosed with advanced lung adenocarcinoma, had EGFR mutation data, and did not undergo surgery from five medical institutes between 2010 and 2016. Subjects were classified according to EGFR mutation status, particularly for exon-specific mutations. EGFR positivity was defined as the presence of mutation and EGFR negativity was defined as wild-type EGFR. EGFR positivity was 38.0%, with the incidence of mutations in E18, E19, E20, and E21 was 3.6%, 51.0%, 3.4%, and 42.0%, respectively. The EGFR positive group survived significantly longer than the negative group (p<0.001), and there was a significant difference in survival among the four EGFR mutation sites (p = 0.003); E19 dels were the only significant factor that lowered mortality (HR: 0.678, p = 0.002), while an E21 mutation was the prognostic factor associated with the most increased mortality (HR: 1.365, p = 0.015). Amongst EGFR positive subjects, the proportion of E19 dels in TKI-responders was significantly higher and that of E21 mutations significantly lower, compared with non-responders. In TKI treatment, mutations in E18 and E20 were not worse factors than the E21 L858R mutation. In conclusion, the presence of EGFR mutations in advanced lung adenocarcinoma can predict a good prognosis; E19 dels prospect to have a better prognosis than other mutations, while an E21 mutation is expected to increase mortality.
DOI
10.1371/journal.pone.0228925
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의과대학 > 의학과 > Journal papers
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