Abstract

Incorporation of molecular analysis of the epidermal growth factor receptor (EGFR) gene into routine clinical practice has shown great promise to provide personalized therapy of the non-small cell lung cancer (NSCLC) in the developed world. However, the genetic testing of EGFR mutations has not yet become routine clinical practice in territories remote from the central regions of Russia. Therefore, we aimed to study the frequency of major types of activating mutations of the EGFR gene in NSCLC patients residing in West Siberia. We examined EGFR mutations in exons 19 and 21 in 147 NSCLC patients (excluding squamous cell lung carcinomas) by real time polymerase chain reaction. EGFR mutations were detected in 28 of the 147 (19%) patients. There were 19 (13%) cases with mutations in exon 19 and 9 cases (6%) in exon 21. Mutations were more frequently observed in women (42%, p=0.000) than in men (1%). A significantly higher incidence of EGFR mutations was observed in bronchioloalveolar carcinomas (28%, p=0.019) and in adenocarcinomas (21%, p=0.024) than in large cell carcinomas, mixed adenocarcinomas, and NOS (4%). The EGFR mutation rate was much higher in never-smokers than in smokers: 38% vs. 3% (p=0.000). The frequency of EGFR mutations in the Kemerovo and Tomsk regions was 19%. The incorporation of molecular analysis of the EGFR gene into routine clinical practice will allow clinicians to provide personalised therapy, resulting in a significant increase in survival rates and improvement in life quality of advanced NSCLC patients.

Highlights

  • Lung cancer remains one of the most common cancers in the world and the leading cause of cancer-related death (Cherdyntseva et al, 2010; Jemal et al, 2010)

  • We aimed to study the frequency of major types of activating mutations of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) patients residing in West Siberia

  • In 2004, several studies demonstrated a significant benefit of tyrosine kinase inhibitor treatment compared to conventional chemotherapy for NSCLC patients harbouring EGFR-activating mutations (Maemondo et al, 2010)

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Summary

Introduction

Lung cancer remains one of the most common cancers in the world and the leading cause of cancer-related death (Cherdyntseva et al, 2010; Jemal et al, 2010). The genetic testing of EGFR mutations has not yet become routine clinical practice in territories remote from the central regions of Russia (Imianitov et al, 2008 ; Ponomareva et al, 2011). Incorporation of molecular analysis of the epidermal growth factor receptor (EGFR) gene into routine clinical practice has shown great promise to provide personalized therapy of the non-small cell lung cancer (NSCLC) in the developed world. The genetic testing of EGFR mutations has not yet become routine clinical practice in territories remote from the central regions of Russia. Conclusions: The incorporation of molecular analysis of the EGFR gene into routine clinical practice will allow clinicians to provide personalised therapy, resulting in a significant increase in survival rates and improvement in life quality of advanced NSCLC patients

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