Comparison of the effectiveness of erlotinib, gefitinib, and afatinib for treatment of non-small cell lung cancer in patients with common and rare EGFR gene mutations
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Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are routinely used to treat non-small cell lung cancer (NSCLC) in patients with common activating mutations of the EGFR gene. The aim of the study was to compare the efficacies of EGFR‑TKIs in patients with common (exon 19 deletions and exon 21 p.Leu858Arg) and rare EGFR mutations. A retrospective analysis of 180 NSCLC patients with common (n=167) and rare (n=13) EGFR mutations treated with erlotinib (n=98), gefitinib (n=66) and afatinib (n=16) was performed. EGFR mutations were determined using RT‑PCR and the EntroGen EGFR Mutations Analysis kit. Partial and complete response (PR and CR), progression‑free survival (PFS), and overall survival (OS) were analyzed. Demographic and clinical factors had no impact on PFS or OS in patients treated with EGFR-TKIs. Erlotinib, gefitinib, and afatinib showed similar efficacies based on treatment response, median PFS, and OS. The type of EGFR mutation had no impact on median OS; however, median PFS was significantly longer in patients with the exon 19 deletion compared to patients with the exon 21 p.Leu858Arg substitution and rare EGFR gene mutations (P=0.013). Patients with common EGFR mutations showed significantly longer median PFS than those with rare EGFR mutations (10 vs. 5 months; P=0.009). Erlotinib, gefitinib, and afatinib show similar efficacies in NSCLC patients with both common and rare EGFR mutations. When undergoing EGFR‑TKI treatment, patients with rare EGFR mutations showed similar OS but poorer PFS. Further investigation into the associations between particular rare EGFR mutations and EGFR-TKIs treatment outcomes is required.
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Uncommon mutations within exons 18-21 are present in up to 23% of EGFRm+ NSCLC tumors.
“Uncommon mutations within exons 18–21 are present in up to 23% of EGFRm+ NSCLC tumors.69–75”
From Afatinib for the treatment of <i>EGFR</i> mutation-positive NSCLC: A review of clinical findings (2020) · cites this paper as [72]
The Introduction (page unavailable) reports rare EGFR mutations in approximately 10% and 14.77% of EGFR-mutated NSCLC patients, and describes mutations across exons 18–21. Patient characteristics (page unavailable) reports 7.2% in this study; its 23% figure refers only to exon 20 insertions among patients with rare mutations, not to uncommon mutations among all EGFR-mutated tumors. The claimed upper prevalence of 23% is therefore not supported by this paper. (LLM, conf=0.88)
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- Authors
- Krawczyk, P., Kowalski, D. M., Ramlau, R., Kalinka-Warzocha, E., Winiarczyk, K., Stencel, K., Powrózek, T., Reszka, K., Wojas-Krawczyk, K., Bryl, M., Wójcik-Superczyńska, M., Głogowski, M., Barinow-Wojewódzki, A., Milanowski, J., & Krzakowski, M.
- Affiliations
- The Maria Sklodowska-Curie National Research Institute of Oncology (PL)
- Poznan University of Medical Sciences (PL)
- Medical University of Lublin (PL)
- ORCID
- Venue
- Oncology Letters
- Publisher
- Spandidos Publications
- Published
- 2017-04-03
- Volume
- 13
- Issue
- 6
- Pages
- 4433-4444
- ISSN
- 1792-1074 (ISSN-L)
- 1792-1082
- PMC
- PMC5453045
- OpenAlex
- W2604580902
- Cited by
- 65
- References
- 22
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 6 · 2023: 7 · 2022: 12 · 2021: 13 · 2020: 7 · 2019: 8 · 2018: 6 · 2017: 2
- FWCI
- 5.20
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Oncology Letters (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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
- non-small cell lung cancer, EGFR tyrosine kinase inhibitors, erlotinib, gefitinib, afatinib, EGFR mutation, exon 19 deletion, uncommon EGFR mutations, progression-free survival, overall survival, treatment response
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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