Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations in China
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EGFR tyrosine kinase inhibitors (TKIs) have been established as standard therapy for EGFR-mutated adenocarcinomas; for non-adenocarcinoma non-small cell lung cancer (NSCLC) patients, this therapy remains debatable.
Stage IIIB/IV patients with non-adenocarcinoma NSCLC who underwent EGFR testing were identified at the Shanghai Chest Hospital from January 2009 to September 2014.
A total of 51 patients with EGFR-sensitizing mutations [26 patients with squamous cell carcinoma (SCC), 15 patients with adenosquamous cell carcinoma (ASC), and 10 patients with large cell lung carcinoma (LCLC)] were available for analysis of EGFR TKI treatment efficacy. The progression-free survival (PFS) for the 51 patients harboring EGFR-sensitizing mutations was 4.93 months (95 % CI 3.93–5.93). The PFS for the SCC, ASC, and LCLC patients was 3.98 months (95 % CI 3.32–4.63), 8.08 months (95 % CI 4.17–12.00), and 4.40 months (95 % CI 1.56–7.24), respectively. Among the 51 non-adenocarcinoma NSCLC patients, the PFS of the non-smokers and smokers was 5.49 months (95 % CI 3.28–7.70) and 3.78 months (95 % CI 2.61–4.95), respectively (P = 0.036). The PFS for the patients with a deletion in exon 19 and for those with an exon 21 L858R mutation was 5.16 months (95 % CI 4.21–6.11) and 4.04 months (95 % CI 2.35–5.73), respectively (P = 0.414).
EGFR TKIs could be an option for the treatment of EGFR-mutated non-adenocarcinoma NSCLC, especially for patients with adenosquamous histology and non-smokers.
KeywordsNon-adenocarcinoma NSCLC EGFR Tyrosine kinase inhibitors
The authors would like to acknowledge support from the Department of Pathology of Shanghai Chest Hospital. We also thank Hua Zhong, Chunlei Shi, Aiqing Gu, Liwen Xiong, and Yizhuo Zhao for their provision of study materials or patients for this study.
This work was supported by Key Projects of the Biomedicine Department, Science and Technology Commission of Shanghai Municipality (Project No. 11411951200). The funders played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Compliance with ethical standards
Conflict of interest
The authors have stated that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Leighl NB, Rekhtman N, Biermann WA et al (2014) Molecular testing for selection of patients with lung cancer for epidermal growth factor receptor and anaplastic lymphoma kinase tyrosine kinase inhibitors: American Society of Clinical Oncology endorsement of the College of American Pathologists/International Association for the study of lung cancer/association for molecular pathology guideline. J Clin Oncol 32:3673–3679CrossRefPubMedGoogle Scholar
- Ohtsuka K, Ohnishi H, Fujiwara M et al (2007) Abnormalities of epidermal growth factor receptor in lung squamous-cell carcinomas, adenosquamous carcinomas, and large-cell carcinomas: tyrosine kinase domain mutations are not rare in tumors with an adenocarcinoma component. Cancer 109:741–750CrossRefPubMedGoogle Scholar
- Thatcher N, Chang A, Parikh P et al (2005) Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomised, placebo-controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet 366:1527–1537CrossRefPubMedGoogle Scholar
- Travis WD, Brambilla E, Muller-Hermelink HK et al (2004) World health organization classification of tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC Press, LyonGoogle Scholar