| Summary: | Objectives: Several new cancer therapies targeting signaling pathways involved in the growth and progression of cancer cells were developed as personalized medicine. Our study aimed to identify epidermal growth factor receptor (<i>EGFR</i>) mutations for TKI treatment in non-small-cell lung cancer (NSCLC) Tunisian patients. Methods: Analysis of the TKI sensitivity mutations in exons 18 to 21 of the <i>EGFR</i> gene and exon 15 of the <i>B-raf</i> gene was performed in 79 formalin fixed-paraffin embedded (FFPE) NSCLC samples using pyrosequencing. Results: <i>EGFR</i> mutations were detected in 34 cases among 79 (43%), with the predominance of the L861Q in exon 21 found in 35.3% of the cases (12 out of 34). Deletions in exon 19 were found in 8 cases (23.5%), and only one young male patient had the T790M mutation. Three patients harbored composite <i>EGFR</i> mutations (p.E746_A750del/p.L861R, p.E746_S752>V/p.S768I, and p.G719A/p.L861Q). Furthermore, the <i>EGFR</i> mutated status was significantly more frequent in female patients (<i>p</i> = 0.019), in non-smoker patients (<i>p</i> = 0.008), and in patients with metastasis (<i>p</i> = 0.044). Moreover, the <i>B-raf</i> V600E was identified in 5 <i>EGFR</i> negative patients among 39 analyzed samples (13.15%). Conclusion: The p.L861Q localized in exon 21 of the <i>EGFR</i> gene was the most common mutation identified in our patients (35.3%), whereas the “classic” <i>EGFR</i> mutations such as Del19 and p.L858R were found in 23.5% and 11.7% of the cases, respectively. Interestingly, most of p.L861X mutation-carrying patients showed good response to TKI treatment. Altogether, our findings suggest a particular distribution of the <i>EGFR</i>-TKIs sensitivity mutations in Tunisian NSCLC patients.
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