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Lung cancer with epidermal growth factor receptor exon 20 mutations is associated with poor gefitinib treatment
Jenn-Yu Wu1, Shang-Gin Wu, Chih-Hsin Yang
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Purpose:
Clinical reports about responsiveness to gefitinib treatment in patients of non-small cell lung cancer (NSCLC) with mutations in exon 20 of epidermal growth factor receptor (EGFR) are limited. To increase understanding of the influence of exon 20 mutations on NSCLC treatment with gefitinib, we investigated the clinical features of lung cancer in patients with exon 20 mutations and analyzed the gefitinib treatment response.
Experimental Design:
We surveyed the clinical data and mutational studies of NSCLC patients with EGFR exon 20 mutations in the National Taiwan University Hospital and reviewed the literature reports about EGFR exon 20 mutations and the gefitinib treatment response.
Results:
Twenty-three patients with mutations in exon 20 were identified. Nine (39%) had coexisting mutations in EGFR exons other than exon 20. Sixteen patients received gefitinib treatment, and a response was noted in 4 patients. The gefitinib response rate of NSCLC with exon 20 mutations was 25%, far lower than those with deletions in exon 19 and L858R mutations. Interestingly, different exon 20 mutations and coexisting mutations seemed to have a different influence on gefitinib response.
Conclusions:
EGFR exon 20 mutations of NSCLC patients result in poorer responsiveness to gefitinib treatment, but variability exists between different individuals.
Insights
Epidermal growth factor receptor (EGFR) exon 20 mutations in non-small cell lung cancer (NSCLC) lead to poor response to gefitinib treatment. However, individual responses to gefitinib vary among patients.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Non-small cell lung cancer (NSCLC) treatment efficacy is influenced by specific genetic mutations.
- Epidermal growth factor receptor (EGFR) mutations are key targets in NSCLC therapy.
- Limited data exists on gefitinib response in NSCLC patients with EGFR exon 20 mutations.
Purpose of the Study:
- To investigate the clinical characteristics of NSCLC in patients with EGFR exon 20 mutations.
- To analyze the treatment response to gefitinib in this patient group.
- To understand the impact of exon 20 mutations on gefitinib efficacy.
Main Methods:
- Retrospective analysis of clinical data and mutational studies from NSCLC patients.
- Inclusion of patients with confirmed EGFR exon 20 mutations from National Taiwan University Hospital.
- Literature review of published data on EGFR exon 20 mutations and gefitinib response.
Main Results:
- Twenty-three NSCLC patients with EGFR exon 20 mutations were identified.
- A gefitinib response rate of 25% was observed in patients with exon 20 mutations, significantly lower than other common EGFR mutations.
- Coexisting mutations in other EGFR exons were present in 39% of patients and appeared to influence gefitinib response.
Conclusions:
- EGFR exon 20 mutations are associated with reduced responsiveness to gefitinib in NSCLC.
- There is significant inter-individual variability in gefitinib response among patients with EGFR exon 20 mutations.
- Further research is needed to elucidate the specific impact of different exon 20 mutations and co-mutations on treatment outcomes.
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