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EGFR mutation status in Middle Eastern patients with non-squamous non-small cell lung carcinoma: A single institution
Samah Naderi1, Claude Ghorra1, Fady Haddad2
1Pathology Department, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Background:
Epidermal growth factor receptor (EGFR) represents an important molecular target in the treatment of lung adenocarcinomas; many anti-EGFR therapies are approved as first line and second-line treatment in patients having metastatic lung adenocarcinomas. The occurrence of this mutation varies in terms of race; it is around 10% in Caucasians and can reach 30% in Asians. Its prevalence in our Middle Eastern region is not well known.
Methods:
Patients diagnosed with non-squamous non-small cell lung carcinomas between March 2013 and March 2015 were included. This study was conducted at Hôtel-Dieu de France University Hospital, a tertiary medical center in Lebanon. EFGR mutations were analyzed using real time PCR technique on the Rotor-Gene Q using Scorpions and ARMS technologies. The following data was collected: the patients' characteristics (age, gender, smoking status, stage), the samples' characteristics (histology subtype, TTF-1 and Napsin A immunostainings, the site and the adequacy and the type of the sample), and the mutational EGFR status (presence and type of mutation). These variables were analyzed using SPSS 20.
Results:
201 patients were included. The mean age was 65.2 years [31-87]; 40.2% were females. 78.1% of the included patients were smokers or ex-smokers. 12.9% of patients had a localized disease, 17.4% a locally advanced disease and 69.7% a metastatic disease. Adenocarcinoma was the main histologic subtype found in 90.5% of patients, followed by large cell carcinoma (3.5%), adenosquamous carcinoma (3.0%) and non-small cell carcinoma not otherwise specified (3.0%). 11.9% of patients had an EGFR mutation: 48% of them presented a deletion on exon 19, 40.0% a L858R mutation on exon 21, 4.0% a G719X mutation in exon 18, 4.0% an insertion in exon 20, and 4% a T790M mutation in exon 20. The presence of an EGFR mutation was significantly associated with the female gender (two-third) (p<0.05) and the non-smoking status (two-third) (p<0.05).
Conclusions:
The prevalence of EGFR mutation (11.9%) detected in our Lebanese population is similar to that observed in the Caucasian population. This mutation is also significantly more frequent in females and non-smokers.
Insights
Epidermal growth factor receptor (EGFR) mutations occur in 11.9% of Lebanese lung cancer patients, similar to Caucasian rates. This EGFR mutation is more common in females and non-smokers.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Epidermal growth factor receptor (EGFR) is a key target for lung adenocarcinoma treatments.
- EGFR mutation prevalence varies significantly by ethnicity, being higher in Asians than Caucasians.
- The prevalence of EGFR mutations in the Middle Eastern population, specifically Lebanon, was not well-documented.
Purpose of the Study:
- To determine the prevalence of EGFR mutations in Lebanese patients with non-squamous non-small cell lung carcinoma.
- To identify common EGFR mutation types and their association with patient demographics and clinical characteristics.
Main Methods:
- Retrospective analysis of 201 patients diagnosed with non-squamous non-small cell lung carcinomas between March 2013 and March 2015.
- EGFR mutations were analyzed using real-time PCR with Scorpions and ARMS technologies.
- Patient and sample characteristics, including histology and mutational status, were collected and analyzed using SPSS 20.
Main Results:
- 11.9% of the 201 patients harbored an EGFR mutation.
- Common mutations included exon 19 deletions (48%) and L858R on exon 21 (40%).
- EGFR mutation presence was significantly associated with female gender and non-smoking status.
Conclusions:
- The prevalence of EGFR mutations in the Lebanese population (11.9%) aligns with that found in Caucasian populations.
- EGFR mutations were found to be significantly more frequent in female and non-smoking patients within this cohort.
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