Rare and complex mutations of epidermal growth factor receptor, and efficacy of tyrosine kinase inhibitor in patients with non-small cell lung cancer

Background There are many complex and rare mutations in the epidermal growth factor receptor ( EGFR ) gene in non-small cell lung cancer (NSCLC) other than the two classical mutations of L858R and exon 19 deletional mutation. The purpose of this study was to investigate the clinical significance of...

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Bibliographic Details
Published in:International journal of clinical oncology 2014-08, Vol.19 (4), p.594-600
Main Authors: Keam, Bhumsuk, Kim, Dong-Wan, Park, Jin Hyun, Lee, Jeong-Ok, Kim, Tae Min, Lee, Se-Hoon, Chung, Doo Hyun, Heo, Dae Seog
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cancer Research
Carcinoma, Non-Small-Cell Lung - drug therapy
Carcinoma, Non-Small-Cell Lung - genetics
Carcinoma, Non-Small-Cell Lung - pathology
Disease-Free Survival
Epidermal growth factor
Erlotinib Hydrochloride
Female
Humans
Inhibitor drugs
Kinases
Lung cancer
Male
Medicine
Medicine & Public Health
Middle Aged
Mutation
Neoplasm Staging
Oncology
Original Article
Protein Kinase Inhibitors - administration & dosage
Quinazolines - administration & dosage
Receptor, Epidermal Growth Factor - genetics
Surgical Oncology
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Summary:Background There are many complex and rare mutations in the epidermal growth factor receptor ( EGFR ) gene in non-small cell lung cancer (NSCLC) other than the two classical mutations of L858R and exon 19 deletional mutation. The purpose of this study was to investigate the clinical significance of rare and complex mutations, and the efficacy of EGFR tyrosine kinase inhibitors (TKIs). Methods We analyzed 1,431 NSCLC patients who were treated with either gefitinib or erlotinib. Exons 18 to 21 of EGFR were analyzed by PCR and subjected to direct sequencing methods. Results Of 306 patients who had EGFR mutation, 24 patients (7.3 %) had complex mutations. The frequency of rare mutations was 10.3 %. Four groups were categorized [group A ( N  = 269): classical mutation alone; group B ( N  = 16): complex mutation with classical mutation; group C ( N  = 16): rare mutation alone or complex mutation with rare mutation; group D ( N  = 5); classical mutation with T790M]; the response rate (RR) to TKI was significantly different between each group (RR = 74.8 % in group A vs. 68.8 % in group B vs. 25.0 % in group C vs. 80.0 % in group D, P  
ISSN:1341-9625
1437-7772
DOI:10.1007/s10147-013-0602-1