Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma
Activating epidermal growth factor receptor (EGFR) mutations in metastatic non-small cell lung cancer (NSCLC) are associated with a high response rate to EGFR tyrosine kinase inhibitor (TKI). The current guidelines recommend routine EGFR mutational analysis prior to initiating first line systemic th...
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| Format: | Article |
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MDPI AG
2017-12-01
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| Series: | Medical Sciences |
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| Online Access: | https://www.mdpi.com/2076-3271/5/4/34 |
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| author | Michelle Levy Liisa Lyon Erika Barbero John Wong Jennifer Marie Suga Danny Sam Minggui Pan |
| author_facet | Michelle Levy Liisa Lyon Erika Barbero John Wong Jennifer Marie Suga Danny Sam Minggui Pan |
| author_sort | Michelle Levy |
| collection | DOAJ |
| description | Activating epidermal growth factor receptor (EGFR) mutations in metastatic non-small cell lung cancer (NSCLC) are associated with a high response rate to EGFR tyrosine kinase inhibitor (TKI). The current guidelines recommend routine EGFR mutational analysis prior to initiating first line systemic therapy. The clinical characteristics including smoking status, histologic type, sex and ethnicity are known to be associated with the incidence of EGFR mutations. We retrospectively analyzed 277 patients with metastatic NSCLC within Kaiser Permanente Northern California (KPNC); among these patients, 83 were positive for EGFR mutations. We performed both univariate and multivariable logistic regressions to identify predictors of EGFR mutations. We found that histologic grade was significantly associated with the incidence of EGFR mutation, regardless of ethnicity, sex and smoking status. In grade I (well differentiated) and II (moderately differentiated), histology was associated with significantly higher incidence of EGFR mutations compared to grade II–III (moderate-to-poorly differentiated) and III (poorly differentiated). Ever-smokers with grade III lung adenocarcinoma had 1.8% incidence of EGFR mutations. This study indicates that histologic grade is a predictive factor for the incidence of EGFR mutations and suggests that for patients with grade II–III or III lung adenocarcinoma, prompt initiation of first-line chemotherapy or immunotherapy is appropriate while awaiting results of EGFR mutational analysis, particularly for patients with history of smoking. |
| first_indexed | 2024-12-11T04:59:52Z |
| format | Article |
| id | doaj.art-fdd001b4ded1470f831a415b16bb742c |
| institution | Directory Open Access Journal |
| issn | 2076-3271 |
| language | English |
| last_indexed | 2024-12-11T04:59:52Z |
| publishDate | 2017-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medical Sciences |
| spelling | doaj.art-fdd001b4ded1470f831a415b16bb742c2022-12-22T01:20:11ZengMDPI AGMedical Sciences2076-32712017-12-01543410.3390/medsci5040034medsci5040034Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung AdenocarcinomaMichelle Levy0Liisa Lyon1Erika Barbero2John Wong3Jennifer Marie Suga4Danny Sam5Minggui Pan6Internal Medicine Residency Program, Kaiser Permanente, Santa Clara, CA 95051, USADivision of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USAInternal Medicine Residency Program, Kaiser Permanente, Santa Clara, CA 95051, USAInternal Medicine Residency Program, Kaiser Permanente, Santa Clara, CA 95051, USADivision of Oncology and Hematology, Kaiser Permanente, Vallejo, CA 94589, USAInternal Medicine Residency Program, Kaiser Permanente, Santa Clara, CA 95051, USAInternal Medicine Residency Program, Kaiser Permanente, Santa Clara, CA 95051, USAActivating epidermal growth factor receptor (EGFR) mutations in metastatic non-small cell lung cancer (NSCLC) are associated with a high response rate to EGFR tyrosine kinase inhibitor (TKI). The current guidelines recommend routine EGFR mutational analysis prior to initiating first line systemic therapy. The clinical characteristics including smoking status, histologic type, sex and ethnicity are known to be associated with the incidence of EGFR mutations. We retrospectively analyzed 277 patients with metastatic NSCLC within Kaiser Permanente Northern California (KPNC); among these patients, 83 were positive for EGFR mutations. We performed both univariate and multivariable logistic regressions to identify predictors of EGFR mutations. We found that histologic grade was significantly associated with the incidence of EGFR mutation, regardless of ethnicity, sex and smoking status. In grade I (well differentiated) and II (moderately differentiated), histology was associated with significantly higher incidence of EGFR mutations compared to grade II–III (moderate-to-poorly differentiated) and III (poorly differentiated). Ever-smokers with grade III lung adenocarcinoma had 1.8% incidence of EGFR mutations. This study indicates that histologic grade is a predictive factor for the incidence of EGFR mutations and suggests that for patients with grade II–III or III lung adenocarcinoma, prompt initiation of first-line chemotherapy or immunotherapy is appropriate while awaiting results of EGFR mutational analysis, particularly for patients with history of smoking.https://www.mdpi.com/2076-3271/5/4/34EGFR mutationlung adenocarcinomahistologic gradeNSCLCerlotinib |
| spellingShingle | Michelle Levy Liisa Lyon Erika Barbero John Wong Jennifer Marie Suga Danny Sam Minggui Pan Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma Medical Sciences EGFR mutation lung adenocarcinoma histologic grade NSCLC erlotinib |
| title | Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma |
| title_full | Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma |
| title_fullStr | Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma |
| title_full_unstemmed | Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma |
| title_short | Histologic Grade Is Predictive of Incidence of Epidermal Growth Factor Receptor Mutations in Metastatic Lung Adenocarcinoma |
| title_sort | histologic grade is predictive of incidence of epidermal growth factor receptor mutations in metastatic lung adenocarcinoma |
| topic | EGFR mutation lung adenocarcinoma histologic grade NSCLC erlotinib |
| url | https://www.mdpi.com/2076-3271/5/4/34 |
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