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12.10.2017 | Original Article – Clinical Oncology | Ausgabe 1/2018

Journal of Cancer Research and Clinical Oncology 1/2018

Are exon 19 deletions and L858R different in early stage lung adenocarcinoma?

Zeitschrift:
Journal of Cancer Research and Clinical Oncology > Ausgabe 1/2018
Autoren:
Yiliang Zhang, Yuan Ma, Yuan Li, Xuxia Shen, Yongfu Yu, Yunjian Pan, Yang Zhang, Su Yu, Difan Zheng, Yue Zhao, Hong Hu, Yihua Sun, Yawei Zhang, Jiaqing Xiang, Haiquan Chen
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00432-017-2526-z) contains supplementary material, which is available to authorized users.
Yiliang Zhang and Yuan Ma have contributed equally to this study.

Abstract

Introduction

Evidence shows that exon 19 deletions (19del) and exon 21 Leu858Arg point mutation (L858R) of EGFR are different in response to EGFR tyrosine kinase inhibitor (EGFR-TKI) therapy in advanced lung cancers. However, the impact of the two mutational types in the early stage lung adenocarcinoma is unknown.

Methods

We enrolled consecutive patients with operable adenocarcinoma which harbored 19del or L858R to investigate the clinicopathologic characteristics and prognostic outcomes.

Results

Between 2008 and 2013, a total of 607 patients with 19del (47.9%) or L858R (52.1%) were included in this study. Clinicopathologic and disease-associated factors were well-balanced between 19del and L858R patients. Both recurrence-free survival (5-year RFS: 37.9% vs. 42.9%, p = 0.075) and overall survival (5-year OS: 64.7% vs. 60.7%, p = 0.741) were similar between the two groups. After relapse, 19del was associated with a better post-recurrence survival (PRS) than L858R (p = 0.016). Multivariate analysis demonstrated that mutational types (HR = 1.521, 95% CI: 1.106–2.093, p = 0.01) and tyrosine kinase inhibitors (TKI) use after recurrence (HR = 0.422, 95% CI: 0.301–0.592, p < 0.001) were independent predictors of PRS. The 19del and L858R patients were similar regarding recurrent patterns, except on pleural/chest wall metastasis (26.0% vs. 12.2%, p = 0.007).

Conclusions

Patients with the early stage lung adenocarcinoma harboring either 19del or L858R share similar RFS and OS. After recurrence, both could benefit from TKI therapy without the need for a second biopsy, but 19del seemed to be associated with better PRS.

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Zusatzmaterial
Supplementary material 1 (DOCX 22 kb)
432_2017_2526_MOESM1_ESM.docx
Literatur
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