P3.09-09 “Prevalence of Epidermal Growth Factor Receptor Mutation in Non-Small Cell Carcinoma Lungs at a Cancer Center in Nepal”

Abstract

Mutations in the epidermal growth factor receptor (EGFR) gene are commonly observed in non-small-cell lung cancer (NSCLC), particularly in adenocarcinoma (AC). The prevalence of EGFR mutations in different parts of the world is well documented but there is lack of information for patients in Nepal. This study aims at exploring the proportion of EGFR mutation among Nepalese patients with NSCLC/AC. A retrospective study was conducted in patients with all lung primary lesions diagnosed as NSCLC/AC and treated at Nepal Cancer Hospital and Research Center from March, 2015 till Feb, 2018. The related information on age, gender, histomorphological diagnosis, geographic distribution, ethnicity and EGFR mutational analysis were collected from the Department of Pathology and Laboratory Medicine at Nepal Cancer Hospital and Research Center, Nepal and were analyzed. Total 106 cases of primary malignant lung lesions diagnosed as NSCLC/AC were evaluated for EGFR mutational analysis. 3%, 12% and 86% were well, moderately and poorly differentiated NSCLC/AC respectively. 21% metastasized to lymphnodes, bone, liver and others and 8% had local invasion into pleura. EGFR mutation were seen in 36%(n38 out of 106) of NSCLC/AC, most common in exon 19(55%) followed by exon 21(37%), exon 20(5%) and both exon 19and20(3%). There was no mutation found in exon 18. Malignancies were predominant in males (M: F=1.3:1) with median age 66years. However, EGFR mutation were predominant in female (M:F=0.6:1). Most of the patients were from Brahman/Chetri community(42%) followed by Newar(30%), Tarai Madhesi(11%), Janajati(10%), Dalit(6%) and Tamang(1%). Despite of being second in population for NSCLC/AC Newars had the most number of EGFR mutation of 16% followed by 10%, 5%, 3% and 2% in Brahman/Chetri, Janajati, Tarai Madhesi and Dalit respectively. Most of the patients were from central Nepal(Kathmandu, Lalitpur, Bhaktapur)(52%) followed by East Nepal(32%) and West Nepal(19%). EGFR mutation in lung cancer in our center was more than one third(36%) which is relatively high when compared to other parts of the world. Most of them were female from Newar community from central part of Nepal. Though rare, mutation in both the exons 19 and 20 were also observed. To our knowledge this is the first report in Nepalese population about EGFR mutation. A detail population base and multicentric studies are recommended to know about the actual prevalence of EGFR mutation and it’s types in the Nepalese lung cancer patients.