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An association of epidermal growth factor receptor mutation subtypes with prognostic prediction and site-specific recurrence in advanced stage lung cancer patients

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Abstract

Background

Concerning the different clinical behavior of epidermal growth factor receptor (EGFR) subtypes in advanced-stage lung cancer patients, the current study aimed to evaluate the clinical, pathological, and prognostic significance of EGFR mutation subtypes, and treatment response in patients with advanced-stage lung cancer.

Methods and results

A retrospective study enrolled a total of 346 patients with advanced-stage lung cancer tested for EGFR mutation. EGFR mutation was analyzed by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Statistical analysis was performed using SPSS version 20.0. EGFR mutation was evident in 38% of patients with the highest prevalence of exon 19 deletions. A higher incidence of 19-deletions and 20-insertions were observed in young patients, while a higher incidence of L858R was noted in old age patients. Patients with de-novo T790M failed to improve their OS by any of the treatment modalities. Patients with de-novo T790M mutation have a higher risk of developing lung, liver, and multiple site metastases while patients with L858R mutation have a higher risk of developing brain metastasis. Additionally, patients with 19 deletion mutation did not improve their OS after receiving conventional chemotherapy hence, they demonstrate better survival only after EGFR-TKIs. Multivariate survival analysis predicted chemotherapy as an independent predictor of OS.

Conclusion

Besides clinicopathological and prognostic consequences of EGFR mutation and mutation subtypes, patients harboring TKI sensitive, or insensitive mutations reveal different secondary disease development and hence should be treated accordingly for better survival. Current findings may provide the basis for a better treatment strategy.

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Data Availability

All data generated or analysed during this study are included in this published article.

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Acknowledgements

Authors 3, 4, and 5 are Ph.D. students working at the Gujarat Cancer & Research Institute affiliated with Gujarat University. Bhoomi Tarapara, Hitarth Patel and Hunayna Bhavnagari are Ph.D. students working at the Gujarat Cancer & Research Institute affiliated with Gujarat University.

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    Authors and Affiliations

    1. Molecular Diagnostic and Research Lab-3, Department of Cancer Biology, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, 380016, India

      Jigna Joshi, Apexa Pandit, Bhoomi Tarapara, Hitarth Patel, Hunayna Bhavnagari & Franky D. Shah

    2. Department of Medical Oncology, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India

      Harsha Panchal

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    Contributions

    All authors contributed to the study conception and design. FDS: has conceptualized the study. Material preparation, data collection was performed by BT, HP and HB. Data analysis was done by JJ and AP. The first draft of the manuscript was written by JJ and all authors commented on previous versions of the manuscript. Review and editing were done by FDS. All authors read and approved the final manuscript.

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    Correspondence to Franky D. Shah.

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    Joshi, J., Pandit, A., Tarapara, B. et al. An association of epidermal growth factor receptor mutation subtypes with prognostic prediction and site-specific recurrence in advanced stage lung cancer patients. Mol Biol Rep 50, 5105–5115 (2023). https://doi.org/10.1007/s11033-023-08432-2

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