Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients
Background: Several deletion and insertion subtypes occur in exon 19 of the epidermal growth factor receptor (EGFR) gene, collectively called exon 19 deletions (del19), and are one of the common EGFR mutations in nonsmall cell lung cancer (NSCLC). Previous studies have shown that del19 subtypes migh...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-01-01
|
| Series: | Journal of Cancer Research and Practice |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00043 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591012134912000 |
|---|---|
| author | Yan-Jei Tang John Wen-Cheng Chang Chen-Yang Huang Yueh-Fu Fang Ching-Fu Chang Cheng-Ta Yang Chih-Hsi Scott Kuo Ping-Chih Hsu Chiao-En Wu |
| author_facet | Yan-Jei Tang John Wen-Cheng Chang Chen-Yang Huang Yueh-Fu Fang Ching-Fu Chang Cheng-Ta Yang Chih-Hsi Scott Kuo Ping-Chih Hsu Chiao-En Wu |
| author_sort | Yan-Jei Tang |
| collection | DOAJ |
| description | Background:
Several deletion and insertion subtypes occur in exon 19 of the epidermal growth factor receptor (EGFR) gene, collectively called exon 19 deletions (del19), and are one of the common EGFR mutations in nonsmall cell lung cancer (NSCLC). Previous studies have shown that del19 subtypes might influence the response to tyrosine kinase inhibitors (TKIs), but their findings have been inconsistent. Therefore, this study aimed to evaluate the impact of del19 subtypes in an Asian population and provide additional evidence on this issue.
Materials and Methods:
NSCLC patients treated at Chang Gung Medical Hospitals between 2011 and 2018 were retrospectively reviewed. Their clinicopathological characteristics, clinical tumor response, progression-free survival (PFS), and overall survival (OS) were collected. PFS was evaluated among different del19 subtypes and EGFR-TKIs.
Results:
This study included 164 patients with NSCLC carrying an EGFR del19 mutation who had detailed information about their del19 subtype and were treated with frontline EGFR-TKIs (39 with afatinib and 125 with gefitinib/erlotinib). In this cohort, del19 subtypes did not influence PFS and OS based on different classifications, including start codon of deletion, the number of deleted nucleotides, or pure deletion versus mixed deletion/insertion/substitution. In addition, afatinib generally showed better PFS than gefitinib/erlotinib, particularly and significantly for patients with the p. E746_A750 mutation, a common 15 nucleotide deletion, or a pure deletion without insertion/substitution.
Conclusion:
In this study, del19 subtypes did not influence PFS and OS with EGFR-TKIs. Afatinib showed better activity than first-generation TKIs and should be preferred for patients with del19 mutations. |
| format | Article |
| id | doaj-art-14b49619fc1441f8825a621dfe11bb4f |
| institution | Kabale University |
| issn | 2311-3006 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Cancer Research and Practice |
| spelling | doaj-art-14b49619fc1441f8825a621dfe11bb4f2025-01-23T05:10:36ZengWolters Kluwer Medknow PublicationsJournal of Cancer Research and Practice2311-30062024-01-01111283810.4103/ejcrp.eJCRP-D-23-00043Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer PatientsYan-Jei TangJohn Wen-Cheng ChangChen-Yang HuangYueh-Fu FangChing-Fu ChangCheng-Ta YangChih-Hsi Scott KuoPing-Chih HsuChiao-En WuBackground: Several deletion and insertion subtypes occur in exon 19 of the epidermal growth factor receptor (EGFR) gene, collectively called exon 19 deletions (del19), and are one of the common EGFR mutations in nonsmall cell lung cancer (NSCLC). Previous studies have shown that del19 subtypes might influence the response to tyrosine kinase inhibitors (TKIs), but their findings have been inconsistent. Therefore, this study aimed to evaluate the impact of del19 subtypes in an Asian population and provide additional evidence on this issue. Materials and Methods: NSCLC patients treated at Chang Gung Medical Hospitals between 2011 and 2018 were retrospectively reviewed. Their clinicopathological characteristics, clinical tumor response, progression-free survival (PFS), and overall survival (OS) were collected. PFS was evaluated among different del19 subtypes and EGFR-TKIs. Results: This study included 164 patients with NSCLC carrying an EGFR del19 mutation who had detailed information about their del19 subtype and were treated with frontline EGFR-TKIs (39 with afatinib and 125 with gefitinib/erlotinib). In this cohort, del19 subtypes did not influence PFS and OS based on different classifications, including start codon of deletion, the number of deleted nucleotides, or pure deletion versus mixed deletion/insertion/substitution. In addition, afatinib generally showed better PFS than gefitinib/erlotinib, particularly and significantly for patients with the p. E746_A750 mutation, a common 15 nucleotide deletion, or a pure deletion without insertion/substitution. Conclusion: In this study, del19 subtypes did not influence PFS and OS with EGFR-TKIs. Afatinib showed better activity than first-generation TKIs and should be preferred for patients with del19 mutations.https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00043afatinibepidermal growth factor receptorerlotinibexon 19 deletiongefitinibnonsmall cell lung cancertyrosine kinase inhibitor |
| spellingShingle | Yan-Jei Tang John Wen-Cheng Chang Chen-Yang Huang Yueh-Fu Fang Ching-Fu Chang Cheng-Ta Yang Chih-Hsi Scott Kuo Ping-Chih Hsu Chiao-En Wu Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients Journal of Cancer Research and Practice afatinib epidermal growth factor receptor erlotinib exon 19 deletion gefitinib nonsmall cell lung cancer tyrosine kinase inhibitor |
| title | Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients |
| title_full | Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients |
| title_fullStr | Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients |
| title_full_unstemmed | Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients |
| title_short | Epidermal Growth Factor Receptor Exon 19 Deletion Subtypes Do Not Influence Survival Outcomes Following First-line Epidermal Growth Factor Receptor-tyrosine Kinase Inhibitors in Advanced Nonsmall Cell Lung Cancer Patients |
| title_sort | epidermal growth factor receptor exon 19 deletion subtypes do not influence survival outcomes following first line epidermal growth factor receptor tyrosine kinase inhibitors in advanced nonsmall cell lung cancer patients |
| topic | afatinib epidermal growth factor receptor erlotinib exon 19 deletion gefitinib nonsmall cell lung cancer tyrosine kinase inhibitor |
| url | https://journals.lww.com/10.4103/ejcrp.eJCRP-D-23-00043 |
| work_keys_str_mv | AT yanjeitang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT johnwenchengchang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT chenyanghuang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT yuehfufang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT chingfuchang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT chengtayang epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT chihhsiscottkuo epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT pingchihhsu epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients AT chiaoenwu epidermalgrowthfactorreceptorexon19deletionsubtypesdonotinfluencesurvivaloutcomesfollowingfirstlineepidermalgrowthfactorreceptortyrosinekinaseinhibitorsinadvancednonsmallcelllungcancerpatients |