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Influence of Chemotherapy on EGFR Mutation Status Among Patients With Non–Small-Cell Lung Cancer

Bai, Hua ; Wang, Zhijie ; Chen, Keneng ; Zhao, Jun ; Lee, J Jack ; Wang, Shuhang ; Zhou, Qinghua ; Zhuo, Minglei ; Mao, Li ; An, Tongtong ; Duan, Jianchun ; Yang, Lu ; Wu, Meina ; Liang, Zhen ; Wang, Yuyan ; Kang, Xiaozheng ; Wang, Jie

Journal of clinical oncology, 2012-09, Vol.30 (25), p.3077-3083 [Periódico revisado por pares]

Alexandria, VA: American Society of Clinical Oncology

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Título:
Influence of Chemotherapy on EGFR Mutation Status Among Patients With Non–Small-Cell Lung Cancer
Autor: Bai, Hua ; Wang, Zhijie ; Chen, Keneng ; Zhao, Jun ; Lee, J Jack ; Wang, Shuhang ; Zhou, Qinghua ; Zhuo, Minglei ; Mao, Li ; An, Tongtong ; Duan, Jianchun ; Yang, Lu ; Wu, Meina ; Liang, Zhen ; Wang, Yuyan ; Kang, Xiaozheng ; Wang, Jie
Assuntos: Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Carcinoma, Non-Small-Cell Lung - blood ; Carcinoma, Non-Small-Cell Lung - drug therapy ; Carcinoma, Non-Small-Cell Lung - enzymology ; Carcinoma, Non-Small-Cell Lung - genetics ; Carcinoma, Non-Small-Cell Lung - pathology ; Chemotherapy, Adjuvant ; Chi-Square Distribution ; China ; Cohort Studies ; DNA, Neoplasm - blood ; ErbB Receptors - antagonists & inhibitors ; ErbB Receptors - genetics ; Female ; Gene Expression Regulation, Enzymologic - drug effects ; Gene Expression Regulation, Neoplastic - drug effects ; Genetic Predisposition to Disease ; Humans ; Lung Neoplasms - blood ; Lung Neoplasms - drug therapy ; Lung Neoplasms - enzymology ; Lung Neoplasms - genetics ; Lung Neoplasms - pathology ; Male ; Medical sciences ; Middle Aged ; Mutation - drug effects ; Neoadjuvant Therapy ; Neoplasm Staging ; ORIGINAL REPORTS ; Palliative Care ; Phenotype ; Pneumology ; Protein Kinase Inhibitors - administration & dosage ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Tumors ; Tumors of the respiratory system and mediastinum
É parte de: Journal of clinical oncology, 2012-09, Vol.30 (25), p.3077-3083
Notas: Hua Bai and Zhijie Wang contributed equally to this article.
Descrição: EGFR mutation is a predictor of epidermal growth factor receptor-tyrosine kinase inhibitor treatment response in patients with non-small-cell lung cancer (NSCLC). However, it remains unclear whether chemotherapy affects EGFR mutation status in NSCLC. We investigated the influence of chemotherapy on EGFR mutations in plasma and tumor tissues from patients with NSCLC. Samples were derived from three cohorts: one, 264 patients with advanced NSCLC who received first-line chemotherapy with matched pre- and postchemotherapy blood samples; two, 63 patients with stages IIb to IIIb disease with pre- and post-neoadjuvant chemotherapy tumor tissues; and three, 79 patients with advanced NSCLC who underwent palliative surgery. EGFR mutation status was determined and analyzed to reveal potential impact of chemotherapy. In the first cohort, EGFR mutations were detected in 34.5% of the prechemotherapy plasma samples (91 of 264) but in only 23.1% of the postchemotherapy plasma samples (61 of 264). The decrease in EGFR mutation rate was statistically significant (P < .001). Patients whose EGFR mutations switched from positive to negative after chemotherapy had a better partial response (PR) than patients with a reverse change (P = .037). A similar decrease in EGFR mutation rate was observed in tissues after neoadjuvant chemotherapy in the second cohort (34.9% [22 of 63] v 19.0% [12 of 63]; P = .013). In the third cohort, 38.0% of the tumors (30 of 79) showed an intratumor heterogeneity of EGFR mutation, whereas 62.0% (49 of 79) were homogeneous, either with EGFR mutation or no mutation. Our results suggest that chemotherapy may reduce EGFR mutation frequency in patients with NSCLC, likely the result of a preferential response of subclones with EGFR mutations in tumors with heterogeneous tumor cell populations.
Editor: Alexandria, VA: American Society of Clinical Oncology
Idioma: Inglês

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Influence of Chemotherapy on EGFR Mutation Status Among Patients With Non–Small-Cell Lung Cancer

Bai, Hua ; Wang, Zhijie ; Chen, Keneng ; Zhao, Jun ; Lee, J Jack ; Wang, Shuhang ; Zhou, Qinghua ; Zhuo, Minglei ; Mao, Li ; An, Tongtong ; Duan, Jianchun ; Yang, Lu ; Wu, Meina ; Liang, Zhen ; Wang, Yuyan ; Kang, Xiaozheng ; Wang, Jie

Alexandria, VA: American Society of Clinical Oncology

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