Efficacy of tyrosine kinase inhibitors inroutine clinical practice : epidermal growth factor mutations and their implications
Ovčariček, Tanja ...
Background: Activating mutations in the epidermal growth factor (EGFR) gene confer sensitivity to the tyrosine kinase inhibitors (TKIs)in patients with advanced nonsmall cell lung cancer (NSCLC). TKI ...treatment efficacy and EGFR mutation implications were evaluatedin clinically selected advanced NSCLC patients treated with TKIs in routine clinical practice.Materials and Methods: A retrospective chart review for clinicopathological characteristics and mutation status (EGFR, KRAS) analysisof 40 consecutive patients treated with TKIs between 2005 and 2010 was performed.Statistical Analysis Used: PFS and OS were estimated by the Kaplan-Meier method, the log-rank test was used to test for differences.The strength of the associations between the EGFR mutation status and clinicopathological characteristics were tested with the Mann-Whitney U-test or the Kruskal-Wallis H-test.Results: The prevalence of EGFR mutations was 45% with a predominance of deletion mutations in exon 19 (55.5%). Significantcorrelations between gender, histology, and EGFR mutations were observed. Median progression-free survival (mPFS) for the entiregroup of patients was 8.7 months and median overall survival (mOS) was not yet reached. Patients with EGFR mutant tumors derivedsignificantly higher benefit from TKI therapy compared to patients with mutation-negative disease; with mPFS of 22.0 vs. 3.2 months(HR: 3.9, 95% CI 1.569.89) and with a trend towards better OS (probability of survival at 12 months 82.0 vs. 63.0%, P = 0.080).Conclusion: We demonstrated that screening for EGFR mutations is reliable in a routine clinical setting and might allow for a betterselection of NSCLC patients for anti-EGFR TKI therapy.
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