A Nationwide Study on the Impact of Routine Testing for EGFR Mutations in Advanced NSCLC Reveals Distinct Survival Patterns Based on EGFR Mutation Subclasses
| Autor: | Ed Schuuring, Ronald A M Damhuis, Chantal C H J Kuijpers, Harry J.M. Groen, Anthonie J. van der Wekken, Léon C van Kempen, Bart Koopman, Stefan M. Willems, Betzabel N. Cajiao Garcia |
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| Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Damage and Repair in Cancer Development and Cancer Treatment (DARE), Targeted Gynaecologic Oncology (TARGON) |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty real-world Afatinib EGFR CELL LUNG-CANCER MOLECULAR-PATHOLOGY survival GEFITINIB molecular diagnostics 03 medical and health sciences 0302 clinical medicine Gefitinib Internal medicine TYROSINE KINASE INHIBITORS SEQUENCE VARIANTS Medicine Clinical significance Lung cancer RC254-282 non-small cell lung cancer EGFR inhibitors AFATINIB business.industry Molecular pathology Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease OPEN-LABEL EFFICACY Confidence interval Cancer registry 1ST-LINE TREATMENT 030104 developmental biology 030220 oncology & carcinogenesis business GROWTH-FACTOR RECEPTOR nationwide medicine.drug |
| Zdroj: | Cancers, 13(14):3641. MDPI AG Cancers Volume 13 Issue 14 Cancers, Vol 13, Iss 3641, p 3641 (2021) |
| ISSN: | 2072-6694 |
| Popis: | EGFR mutation analysis in non-small-cell lung cancer (NSCLC) patients is currently standard-of-care. We determined the uptake of EGFR testing, test results and survival of EGFR-mutant NSCLC patients in the Netherlands, with the overall objective to characterize the landscape of clinically actionable EGFR mutations and determine the role and clinical relevance of uncommon and composite EGFR mutations. Non-squamous NSCLC patients diagnosed in 2013, 2015 and 2017 were identified in the Netherlands Cancer Registry (NCR) and matched to the Dutch Pathology Registry (PALGA). Overall, 10,254 patients were included. Between 2013–2017, the uptake of EGFR testing gradually increased from 72.7% to 80.9% (p < 0.001). Multi-gene testing via next-generation sequencing (increased from 7.8% to 78.7% (p < 0.001), but did not affect the number of detected EGFR mutations (n = 925 11.7% 95% confidence interval (CI), 11.0–12.4) nor the distribution of variants. For patients treated with first-line EGFR inhibitors (n = 651), exon 19 deletions were associated with longer OS than L858R (HR 1.58 95% CI, 1.30–1.92 p < 0.001) or uncommon, actionable variants (HR 2.13 95% CI, 1.60–2.84 0.001). Interestingly, OS for patients with L858R was similar to those with uncommon, actionable variants (HR 1.31 95% CI, 0.98–1.75 p = 0.069). Our analysis indicates that grouping exon 19 deletions and L858R into one class of ‘common’ EGFR mutations in a clinical trial may mask the true activity of an EGFR inhibitor towards specific mutations. |
| Databáze: | OpenAIRE |
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