187P - Common and rare EGFR mutations in non-small cell lung cancer

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Biomarkers
Lung and other Thoracic Tumours
Presenter Alma Campos Parra
Citation Annals of Oncology (2014) 25 (suppl_4): iv58-iv84. 10.1093/annonc/mdu326
Authors A.D. Campos Parra1, A.F. Cardona2, L. Corrales3, R. Sánchez Reyes1, J. Rodríguez2, C.A. Vargas2, H. Carranza2, J. Otero2, R. Rosell4, O. Arrieta1
  • 1Thoracic Oncology Unit And Experimental Oncology Laboratory, National Cancer Institute (INCan), 14080 - DF/MX
  • 2Clinical And Translational Oncology Group, Fundacion Sta Fe de BogotaInstituto de Oncologia, CO- - Bogota/CO
  • 3Hospital San Juan De Dios-ccss (san José, Costa Rica), Medical Oncology, San Jose/CR
  • 4Medical Oncology Service, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, 08916 - Badalona/ES

Abstract

Aim

Background: In non-small cell lung cancer (NSCLC), the association between common EGFR mutations (Del EX19/ L858R) with EGFR tyrosine kinase inhibitors (EGFR-TKIs) has been well established. Not so for rare EGFR mutations, not even their impact on treatment response to platinum-based chemotherapy.

Methods

We analyzed 188 NSCLC patients’ harbouring EGFR mutations from Mexico, Colombia and Costa Rica. Patients were treated according to international guidelines for the treatment of lung cancer. As first line treatment, 64.1% receive platinum-based chemotherapy and 30.8% receive EGFR-TKIs, after chemotherapy progression. Clinical-pathological characteristics and presence of common and rare EGFR mutations regarding treatment response were analysed. Protocol is registered with ClinicalTrials.gov, number NCT01023828.

Results

Of all patients, 79.5% had common and 20.5% had rare EGFR mutations. Lepidic and acinar adenocarcinoma were associated with common EGFR mutation (p = 0.010). Patients who harboured common EGFR mutations had higher response rates to EGFR-TKIs versus those who had rare EGFR mutations (63.8% cf 32.4%, p < 0.001). Women had increased progression-free survival (PFS) compared with men (p = 0.02). Median PFS and overall survival (OS) were better for patients harbouring common EGFR mutations (p < 0.001).

Conclusions

Our findings suggested that patients who harboured rare EGFR mutations only could receive platinum-based chemotherapy as first-line treatment and EGFR-TKIs could be reserved as second- or third-line treatment.

Disclosure

All authors have declared no conflicts of interest.