[EGFR mutations in patients with advanced NSCLC].

Area of Science:

• Oncology
• Genetics
• Pharmacology

Background:

• Non-small cell lung cancer (NSCLC) management includes molecular targeted therapy using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).
• EGFR gene mutations, specifically exon 19 deletions and exon 21 (L858R) point mutations, are established biomarkers for predicting TKI treatment response.
• Assessing the incidence and impact of EGFR mutations in European NSCLC patients is crucial for optimizing treatment strategies.

Purpose of the Study:

• To determine the frequency of EGFR mutations in a large European cohort of advanced NSCLC patients.
• To evaluate the effectiveness of EGFR-TKI treatment in patients with and without EGFR mutations.
• To establish the predictive value of EGFR mutations for treatment outcomes in NSCLC.

Main Methods:

• Genetically tested 613 patients with advanced NSCLC (stages IIIB, IV).
• Evaluated treatment effects in 410 patients receiving EGFR-TKI therapy.
• Analyzed survival data using Kaplan-Meier method and log-rank test for statistical comparison.

Main Results:

• EGFR mutations were found in 11.9% of patients (73/613), with exon 19 deletions in 49 and exon 21 mutations in 22.
• Higher EGFR mutation incidence observed in adenocarcinoma (14.9%), women (20.2%), and non-smokers (29.9%).
• Patients with EGFR mutations showed significantly longer progression-free survival (PFS: 7.2 vs 2.0 months) and overall survival (OS: 14.5 vs 7.5 months) compared to wild-type EGFR patients when treated with EGFR-TKI.

Conclusions:

• The incidence of EGFR mutations in this European cohort aligns with previous findings, with higher rates in adenocarcinoma, women, and non-smokers.
• EGFR mutations strongly predict a favorable response to EGFR-TKI treatment, confirming their role as predictive biomarkers.
• Routine genetic testing for EGFR mutations is recommended as a standard diagnostic procedure for NSCLC patients to guide targeted therapy selection.