Cited by 96Lung Cancer Treatments and MutationsLung Cancer Diagnosis and TreatmentHER2/EGFR in Cancer Research

Clinical and molecular characteristics of non-small-cell lung cancer (NSCLC) harboring EGFR mutation: results of the nationwide French Cooperative Thoracic Intergroup (IFCT) program

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Leduc, C., Merlio, J.P., Besse, B., Blons, H., Debieuvre, D., Bringuier, P.P., Monnet, I., Rouquette, I. +12 more·2017·Annals of Oncology

Abstract

Background EGFR mutations cause inconsistent response to EGFR tyrosine-kinase inhibitors (TKI). To better understand these features, we reviewed all cases of EGFR-mutated non-small-cell lung cancer collected in the Biomarkers France database.Patients and methods Of 17 664 patients, 1837 (11%) with EGFR-mutated non-small-cell lung cancer were retrospectively analyzed for clinical and molecular characteristics. Results were correlated with survival and treatment response for the 848 stage IV patients.Results EGFR exon 18, 19, 20 and 21 mutations were found in 102 (5.5%), 931 (51%), 102 (5.5%) and 702 (38%) patients, respectively. Over 50% of exon 18 and 20 mutated patients were smokers. The median follow-up was 51.7 months. EGFR mutation type was prognostic of overall survival (OS) versus wild-type {exon 19: hazard ratio (HR)=0.51 [95% confidence interval (CI): 0.41-0.64], P < 0.0001; exon 21: HR = 0.76 (95% CI: 0.61-0.95), P = 0.002; exon 20: HR = 1.56 (95% CI: 1.02-2.38), P = 0.004}. EGFR mutation type was prognostic of progression-free survival versus wild-type [exon 19: HR = 0.62 (95% CI: 0.49-0.78), P < 0.0001; exon 20: HR = 1.46 (95% CI: 0.96-2.21), P = 0.07]. First-line treatment choice did not influence OS in multivariate analysis. First-line TKI predicted improved progression-free survival versus chemotherapy [HR = 0.67 (95% CI: 0.53-0.85), P = 0.001]. OS was longer for del19 versus L858R, which was associated with better OS compared with other exon 21 mutations, including L861Q. TKI improved survival in patients with exon 18 mutations, while chemotherapy was more beneficial for exon 20-mutated patients.Conclusion EGFR mutation type can inform the most appropriate treatment. Therapeutic schedule had no impact on OS in our study, although TKI should be prescribed in first-line considering the risk of missing the opportunity to use this treatment.

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Crossref · 10.1093/annonc/mdx404

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Authors
Leduc, C., Merlio, J. P., Besse, B., Blons, H., Debieuvre, D., Bringuier, P. P., Monnet, I., Rouquette, I., Fraboulet-Moreau, S., Lemoine, A., Pouessel, D., Mosser, J., Vaylet, F., Langlais, A., Missy, P., Morin, F., Moro-Sibilot, D., Cadranel, J., Barlesi, F., & Beau-Faller, M.
Affiliations
  • Hôpitaux Universitaires de Strasbourg (FR)
  • Université de Bordeaux (FR)
  • Institut Gustave Roussy (FR)
  • Inserm (FR)
  • Groupe Hospitalier de la Région de Mulhouse et Sud Alsace (FR)
  • Lyon 1 Université (FR)
  • Hôpital Intercommunal de Créteil (FR)
  • Centre Hospitalier Universitaire de Toulouse (FR)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • Centre Hospitalier Universitaire de Rennes (FR)
  • Hôpital d'instruction des Armées Percy (FR)
  • Intergroupe Francophone de Cancérologie Thoracique (FR)
  • Sorbonne Université (FR)
Venue
Annals of Oncology
Publisher
Elsevier BV
Published
2017-11
Volume
28
Issue
11
Pages
2715-2724
ISSN
0923-7534 (ISSN-L)
OpenAlex
W2761632169
Cited by
96
References
25
Citations by year
2026: 3 · 2025: 6 · 2024: 10 · 2023: 11 · 2022: 11 · 2021: 22 · 2020: 12 · 2019: 12 · 2018: 6 · 2017: 1
FWCI
7.01
Type
journal article
Language
en
Open access
Locations
  • Annals of Oncology (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
Keywords
EGFR-mutant non-small cell lung cancer, EGFR tyrosine kinase inhibitors, EGFR exon 19 deletion, L858R mutation, exon 20 insertion, prognostic factors, overall survival, progression-free survival, first-line therapy, smoking, stage IV lung cancer, treatment response
MeSH terms
Carcinoma, Non-Small-Cell Lung, Follow-Up Studies, France, Humans, Lung Neoplasms, Mutation, Prognosis, Retrospective Studies, Biomarkers, Tumor, Survival Rate, Protein Kinase Inhibitors, ErbB Receptors

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