Lung Cancer: Lung Cancer III |

Prevalence of Tissue EGFR Mutation in Patients of Adenocarcinoma Lung and Its Ability to Predict Response to Tyrosine Kinase Inhibitors FREE TO VIEW

Ashutosh Dhanuka, MD; Anant Mohan, MD; Randeep Guleria, DM; Gopi Khilnani, MD; Karan Madan, DM; Vijay Hadda, MD; Alpana Saxena, MD
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All India Institute of Medical Sciences, New Delhi, India

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):724A. doi:10.1016/j.chest.2016.08.819
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SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: To estimate the prevalence of tissue EGFR mutation in patients of adenocarcinoma lung and its predictive value on treatment response to TKIs

METHODS: Treatment naive patients of adenocarcinoma lung were recruited. Al patients underwent complete staging and tissue EGFR mutation analysis using DNA extraction and Polymerase chain reaction. Patients were treated with Gefitinib if they were EGFR positive and platinum based doublet chemotherapy if they were EGFR negative. Treatment response was evaluated after 3 months of Gefitinib / 4 cycles of chemotherapy by using CT-PET scan. Prevalence tissue EGFR was estimated and response correlation to EGFR mutation was done using student t-test

RESULTS: 102 patients were enrolled (61 % males, mean age of 56.2 (SD 10.2) years. 39 % were never smokers, 31% were current smokers and 30 % were reformed smokers. Tissue EGFR mutation was seen in 21 patients (20.6%), exon 18 mutation in 1 patient, exon 19 in 14 patients, exon 20 in 1 patient and exon 21 in 5 patients. 58 patients completed response evaluation at 3 months/ 4 cycles. Of these 17 were EGFR positive and 41 were EGFR negative. The response rates in both arms were: complete response 6% vs 0 %, partial response 41 % vs 27%, stable disease 12% vs 22%, progressive disease 18% vs 17%, and death rate 23% vs 34%. Disease control rate was 47 % in EGFR positive patients 27% in EGFR negative patients (p=0.18). Overall response rate was 59 % in EGFR positive patients vs 49% in EGFR negative patients (p = 0.48).

CONCLUSIONS: Tissue EGFR mutation rate was 20.6%. Patients who are Tissue EGFR mutation positive show better response if treated with TKIs than patients who are EGFR negative and receive conventional chemotherapy although the difference is not statistically significant probably due to a small sample size.

CLINICAL IMPLICATIONS: EGFR positivity in Non small cell Lung Cancer offers better prospects of clinical response if patients are treated with TKIs.

DISCLOSURE: The following authors have nothing to disclose: Ashutosh Dhanuka, Anant Mohan, Randeep Guleria, Gopi Khilnani, Karan Madan, Vijay Hadda, Alpana Saxena

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