Lack of prognostic value of EGFR mutations in primary resected non-small cell lung cancer

Abstract

To investigate the prognostic value of epidermal growth factor receptor (EGFR) mutations in a series of Taiwanese patients with primary resected lung adenocarcinomas never treated with epidermal growth factor receptor tyrosine kinase (TK) inhibitor. A total of 27 of 35 patients whose EGFR mutational status in exons 18, 19, and 21 of the TK domain had been previously determined using nested polymerase chain reaction (PCR) were included in this retrospective study. All 27 patients underwent potentially curative pulmonary resection. Clinicopathological information was obtained from patient records and pathology reports. Disease-free survival (DFS) and overall survival (OS) of patients were estimated with the Kaplan-Meier method, and Cox regression model was used for multivariate analysis. Heterozygous EGFR mutations were detected in 15 of 27 patients (55.5%). There was no significant difference in DFS between patients with wild-type EGFR (median, 16.87 months) and mutant EGFR (median, 18.13 months; P = 0.83). No significant difference in OS was also noted between the wild-type and mutant groups (P = 0.45, median follow-up 22.6 months). Cox regression model and multivariate analysis of survival difference by age, stage, histology, and adjuvant treatment did not reach statistical significance. EGFR mutations do not have significant prognostic value in primary resected non-small cell lung cancer (NSCLC), and further well-designed large prospective studies are warranted to determine the prognostic value of EGFR mutations in NSCLC.