Abstract
BackgroundThe purpose of this study was to develop a cost-effective approach for the determination of EGFR and KRAS mutations in formalin-fixed paraffin-embedded (FFPE) non-small cell lung cancer (NSCLC) and colorectal cancer (CRC) samples from Chinese patients based on a sensitive pyrosequencing (PS) technique.MethodsThe NSCLC and CRC cell lines were tested to determine the limitation of detection and reproducibility of the PS method. In addition, 494 NSCLC and 1099 CRC patient samples were assayed by PS to evaluate the EGFR or KRAS mutation patterns according to the clinicopathological features.ResultsThe PS assay was able to reproducibly detect as few as 2 % mutant alleles with excellent linearity. EGFR mutations were detected in 35.63 % of the NSCLC samples, and KRAS mutations were detected in 39.76 % of the CRC samples. EGFR mutations were more frequently observed to be significant by multivariate analysis in NSCLC patients who were 65 years old or younger (OR = 2.51), had a nonsmoking history (OR = 3.63), and adenocarcinoma (OR = 3.57), but not in females (OR = 0.64). KRAS mutations were more frequently detected in CRC patients who were female (OR = 1.64) and 50 years old or older (OR = 4.17), and had adenocarcinoma (OR = 2.41).ConclusionsThis is the first extensive validation of PS on FFPE samples using the detection of EGFR exons 18–21 mutations and KRAS exon 2 mutations. Our results demonstrate the utility of PS analysis for the detection of somatic EGFR and KRAS mutations in clinical samples and provide important clinical and molecular characteristics of NSCLC and CRC from Chinese patients.Electronic supplementary materialThe online version of this article (doi:10.1186/s13046-015-0179-9) contains supplementary material, which is available to authorized users.
Highlights
Non-small cell lung cancer (NSCLC) and metastatic colorectal cancer are the most common cancers and the leading causes of cancer mortality [1]
The designed pyrosequencing assay was further tested with the known mutant non-small cell lung cancer (NSCLC)- and colorectal cancer (CRC)-formalin-fixed paraffin-embedded (FFPE) tissues (Additional file 1: Table S3)
Mixtures of DNA from epidermal growth factor receptor (EGFR) or Kirsten rat sarcoma viral oncogene homolog (KRAS) cell lines were analyzed in triplicate and in parallel by pyrosequencing and dideoxy sequencing methods to analyze the limit of detection and assay linearity (Additional file 1: Figures S2–S5, Tables S5–S6). a To assess the limit of detection, cell line DNA was mixed to produce samples containing differing proportions of mutant alleles
Summary
Non-small cell lung cancer (NSCLC) and metastatic colorectal cancer (mCRC) are the most common cancers and the leading causes of cancer mortality [1]. Accurate incidence rates of EGFR and KRAS mutations are critical to reckon the effectiveness of molecular-targeted agents as personalized treatment for advanced NSCLC and mCRC patients in any given population. The currently available data show that the frequency of NSCLC EGFR mutations in patients from mainland China varies from 19 to 56 % [9, 15,16,17], and the KRAS mutation rate in Chinese patients with CRC is 20–62 % [18,19,20]. The purpose of this study was to develop a cost-effective approach for the determination of EGFR and KRAS mutations in formalin-fixed paraffin-embedded (FFPE) non-small cell lung cancer (NSCLC) and colorectal cancer (CRC) samples from Chinese patients based on a sensitive pyrosequencing (PS) technique
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