Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types
Abstract Background Epidermal growth factor receptor (EGFR) mutations in non–small-cell lung cancer predict sensitivity to EGFR tyrosine kinase inhibitors (TKIs). EGFR mutation types are associated with efficacy of EGFR TKIs. We investigated the clinical outcomes of afatinib, erlotinib, and gefitini...
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| Format: | Article |
| Language: | English |
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BMC
2021-01-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-020-07765-6 |
| _version_ | 1818607085094436864 |
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| author | Sojung Park Sung Yong Lee Dojin Kim Yun Su Sim Jeong-Seon Ryu Juwhan Choi Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Jung Hyun Chang |
| author_facet | Sojung Park Sung Yong Lee Dojin Kim Yun Su Sim Jeong-Seon Ryu Juwhan Choi Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Jung Hyun Chang |
| author_sort | Sojung Park |
| collection | DOAJ |
| description | Abstract Background Epidermal growth factor receptor (EGFR) mutations in non–small-cell lung cancer predict sensitivity to EGFR tyrosine kinase inhibitors (TKIs). EGFR mutation types are associated with efficacy of EGFR TKIs. We investigated the clinical outcomes of afatinib, erlotinib, and gefitinib according to EGFR mutation type in patients with lung adenocarcinoma. Methods Between May 2010 and December 2018, we investigated 363 patients with advanced lung adenocarcinoma harboring EGFR mutations who received EGFR TKIs. Efficacies of EGFR TKIs such as response rate, progression-free survival (PFS), and overall survival (OS) were retrospectively evaluated according to exon 19 deletion (E19del), L858R point mutation (L858R) and uncommon mutations. Results The frequency of E19del was 48.2%, that of L858R was 42.4%, and that of uncommon mutations was 9.4%. E19del and L858R were associated with superior PFS and OS compared with uncommon mutations. Erlotinib showed significantly inferior OS than other TKIs (30.8 ± 3.3 in erlotinib vs. 39.1 ± 4.3 in afatinib vs. 48.4 ± 6.3 in gefitinib; p = 0.031) in patients with L858R. Gefitinib showed significantly inferior PFS (4.6 ± 1.1 in gefitinib vs. 11.6 ± 2.7 in afatinib vs. 10.6 ± 2.7 in erlotinib; p = 0.049) in patients with uncommon mutations. Conclusion Afatinib was significantly associated with a longer PFS, presenting constant effectiveness in all EGFR mutation types. Caution may be needed on the use of erlotinib for L858R and the use of gefitinib for uncommon EGFR mutations. |
| first_indexed | 2024-12-16T14:21:08Z |
| format | Article |
| id | doaj.art-23dd74a033ae4c50bd6b27ecab10c314 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-16T14:21:08Z |
| publishDate | 2021-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-23dd74a033ae4c50bd6b27ecab10c3142022-12-21T22:28:30ZengBMCBMC Cancer1471-24072021-01-012111910.1186/s12885-020-07765-6Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation typesSojung Park0Sung Yong Lee1Dojin Kim2Yun Su Sim3Jeong-Seon Ryu4Juwhan Choi5Su Hwan Lee6Yon Ju Ryu7Jin Hwa Lee8Jung Hyun Chang9Division of Pulmonary and Critical Care Medicine, College of Medicine, Ewha Womans UniversityDivision of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro HospitalDivision of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon HospitalDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart HospitalDepartment of Internal Medicine, Inha University College of MedicineDivision of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University Guro HospitalDivision of Pulmonary and Critical Care Medicine, College of Medicine, Ewha Womans UniversityDivision of Pulmonary and Critical Care Medicine, College of Medicine, Ewha Womans UniversityDivision of Pulmonary and Critical Care Medicine, College of Medicine, Ewha Womans UniversityDivision of Pulmonary and Critical Care Medicine, College of Medicine, Ewha Womans UniversityAbstract Background Epidermal growth factor receptor (EGFR) mutations in non–small-cell lung cancer predict sensitivity to EGFR tyrosine kinase inhibitors (TKIs). EGFR mutation types are associated with efficacy of EGFR TKIs. We investigated the clinical outcomes of afatinib, erlotinib, and gefitinib according to EGFR mutation type in patients with lung adenocarcinoma. Methods Between May 2010 and December 2018, we investigated 363 patients with advanced lung adenocarcinoma harboring EGFR mutations who received EGFR TKIs. Efficacies of EGFR TKIs such as response rate, progression-free survival (PFS), and overall survival (OS) were retrospectively evaluated according to exon 19 deletion (E19del), L858R point mutation (L858R) and uncommon mutations. Results The frequency of E19del was 48.2%, that of L858R was 42.4%, and that of uncommon mutations was 9.4%. E19del and L858R were associated with superior PFS and OS compared with uncommon mutations. Erlotinib showed significantly inferior OS than other TKIs (30.8 ± 3.3 in erlotinib vs. 39.1 ± 4.3 in afatinib vs. 48.4 ± 6.3 in gefitinib; p = 0.031) in patients with L858R. Gefitinib showed significantly inferior PFS (4.6 ± 1.1 in gefitinib vs. 11.6 ± 2.7 in afatinib vs. 10.6 ± 2.7 in erlotinib; p = 0.049) in patients with uncommon mutations. Conclusion Afatinib was significantly associated with a longer PFS, presenting constant effectiveness in all EGFR mutation types. Caution may be needed on the use of erlotinib for L858R and the use of gefitinib for uncommon EGFR mutations.https://doi.org/10.1186/s12885-020-07765-6Epidermal growth factor receptorNon-small cell lung cancerAdenocarcinomaSurvivalTyrosine kinase inhibitor |
| spellingShingle | Sojung Park Sung Yong Lee Dojin Kim Yun Su Sim Jeong-Seon Ryu Juwhan Choi Su Hwan Lee Yon Ju Ryu Jin Hwa Lee Jung Hyun Chang Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types BMC Cancer Epidermal growth factor receptor Non-small cell lung cancer Adenocarcinoma Survival Tyrosine kinase inhibitor |
| title | Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| title_full | Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| title_fullStr | Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| title_full_unstemmed | Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| title_short | Comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| title_sort | comparison of epidermal growth factor receptor tyrosine kinase inhibitors for patients with lung adenocarcinoma harboring different epidermal growth factor receptor mutation types |
| topic | Epidermal growth factor receptor Non-small cell lung cancer Adenocarcinoma Survival Tyrosine kinase inhibitor |
| url | https://doi.org/10.1186/s12885-020-07765-6 |
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