Cited by 182Lung Cancer Treatments and MutationsHER2/EGFR in Cancer ResearchLung Cancer Diagnosis and Treatment

A comprehensive review of uncommon EGFR mutations in patients with non-small cell lung cancer

Tu, Hai-Yan, Ke, E-E, Yang, Jin-Ji, Sun, Yue-Li, Yan, Hong-Hong, Zheng, Ming-Ying, Bai, Xiao-Yan, Wang, Zhen +15 more·2017·Lung Cancer

Abstract

Introduction Patients with non-small cell lung cancer (NSCLC) harboring uncommon epidermal growth factor receptor (EGFR) mutations are a heterogeneous group exhibiting differential responses to EGFR inhibitors. This retrospective study reviews the prevalence of uncommon EGFR mutations in a Chinese NSCLC cohort and the clinical characteristics and efficacy of EGFR tyrosine kinase inhibitors (TKIs) associated with these patients.Materials andmethods A total of 5363 lung cancer patients were screened and underwent EGFR genotyping at the Guangdong Lung Cancer Institute. Of those with uncommon EGFR mutations, the clinical characteristics and responses to EGFR-TKIs were reviewed retrospectively.Results Uncommon EGFR mutations were observed in 218 patients, comprising 11.9% of all patients with documented EGFR mutations. More smokers (30.7% vs. 24.3%, P=0.039) and males (54.1% vs. 44.4%, P=0.007) were among the patients with uncommon mutations compared with common mutations. The most frequent uncommon mutations were exon 20 insertions (30.7%, n=67), followed by G719X mutations (21.1%, n=46) and compound L858R mutations (17.0%, n=37). Favorable efficacy was observed in patients harboring compound L858R or G719X mutations, with a median progression-free survival (PFS) of 15.2 (95% CI: 8.7-21.7) or 11.6 (95% CI: 3.6-19.6) months, respectively. The median PFS of those with the T790M mutation or an exon 20 insertion was 1.0 (95% CI: 0.0-2.2) and 3.0 (95% CI: 1.3-4.7) months, respectively.Conclusion This study reviewed the prevalence of uncommon EGFR mutations and their sensitivity to EGFR-TKIs. Favorable responses were observed in patients with G719X and compound L858R mutations, indicating that they may benefit from EGFR-TKIs as a first-line therapy.

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Crossref · 10.1016/j.lungcan.2017.11.005

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Authors
Tu, H.-Y., Ke, E.-E., Yang, J.-J., Sun, Y.-L., Yan, H.-H., Zheng, M.-Y., Bai, X.-Y., Wang, Z., Su, J., Chen, Z.-H., Zhang, X.-C., Dong, Z.-Y., Wu, S.-P., Jiang, B.-Y., Chen, H.-J., Wang, B.-C., Xu, C.-R., Zhou, Q., Mei, P., Luo, D.-L., Zhong, W.-Z., Yang, X.-N., & Wu, Y.-L.
Affiliations
  • Guangdong General Hospital (CN)
  • Southern Medical University (CN)
Corresponding author
Wu, Yi-Long
Venue
Lung Cancer
Publisher
Elsevier BV
Published
2017-12
Volume
114
Pages
96-102
ISSN
0169-5002 (ISSN-L)
OpenAlex
W2768053061
Cited by
182
References
30
Citations by year
2026: 6 · 2025: 8 · 2024: 13 · 2023: 19 · 2022: 30 · 2021: 25 · 2020: 42 · 2019: 26 · 2018: 13
FWCI
18.39
Type
journal article
Language
en
Open access
closed
Locations
  • Lung Cancer (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Hangzhou Science and Technology Bureau (2014Y2-00050, 201402031)
  • National Health and Family Planning Commission of the People's Republic of China (2014Y2-00050, 201402031)
  • National Key Research and Development Program of China (2014Y2-00050, 201402031)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
Keywords
EGFR mutation, non-small cell lung cancer, EGFR tyrosine kinase inhibitors, exon 20 insertion, G719X mutation, T790M mutation, progression-free survival, treatment response, smoking, Chinese patients
MeSH terms
Erlotinib Hydrochloride, Gefitinib, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Exons, Female, Genotype, Humans, Lung Neoplasms, Male, Middle Aged, Mutation, Predictive Value of Tests, Quinazolines, Retrospective Studies, Smoking, Disease-Free Survival, Asian People, Protein Kinase Inhibitors, ErbB Receptors

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