Impact of EGFR Mutation Detection Methods on the Efficacy of Erlotinib in Patients with Advanced EGFR-Wild Type Lung AdenocarcinomaReport as inadecuate




Impact of EGFR Mutation Detection Methods on the Efficacy of Erlotinib in Patients with Advanced EGFR-Wild Type Lung Adenocarcinoma - Download this document for free, or read online. Document in PDF available to download.

Introduction

Methods used for epidermal growth factor receptor EGFR mutation testing vary widely. The impact of detection methods on the rates of response to EGFR-tyrosine kinase inhibitors TKIs in EGFR-wild type wt lung adenocarcinoma patients is unknown.

Methods

We recruited the Group-I patients to evaluate the efficacy of erlotinib in patients with EGFR-wt lung adenocarcinoma by either direct sequencing DS or mutant type-specific sensitive MtS methods in six medical centers in Taiwan. Cross recheck of EGFR mutations was performed in patients who achieved objective response to erlotinib and had adequate specimens. The independent Group-II lung adenocarcinoma patients whose EGFR mutation status determined by DS were recruited to evaluate the potential limitations of three MtS methods.

Results

In Group-I analysis, 38 of 261 EGFR-wt patients 14.6% achieved partial response to erlotinib treatment. Nineteen patients 50.0% had adequate specimens for cross recheck of EGFR mutations and 10 of them 52.6% had changes in EGFR mutation status, 5 in 10 by DS and 5 in 9 by MtS methods originally. In Group-II analysis, 598 of 996 lung adenocarcinoma patients 60.0% had detectable EGFR mutations. The accuracy rates of the three MtS methods, MALDI-TOF MS, Scorpions ARMS and Cobas, were 87.8%, 86.8% and 85.8%, respectively.

Conclusions

A significant portion of the erlotinib responses in EGFR-wt lung adenocarcinoma patients were related to the limitations of detection methods, not only DS but also MtS methods with similar percentages. Prospective studies are needed to define the proper strategy for EGFR mutation testing.



Author: Jeng-Sen Tseng , Chih-Liang Wang , Ming-Shyan Huang, Chung-Yu Chen, Cheng-Yu Chang, Tsung-Ying Yang, Chi-Ren Tsai, Kun-Chieh Chen

Source: http://plos.srce.hr/



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