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B.P. Singh



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    P1.11 - Poster Session 1 - NSCLC Novel Therapies (ID 208)

    • Event: WCLC 2013
    • Type: Poster Session
    • Track: Medical Oncology
    • Presentations: 1
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      P1.11-025 - EGFR mutation status in adenocarcinoma lung: A single centre experience from Northern India (ID 1967)

      09:30 - 09:30  |  Author(s): B.P. Singh

      • Abstract

      Background
      Epidermal Growth Factor Receptor (EGFR) has emerged as an important molecular marker with a therapeutic implication in many malignancies including lung cancer. The tyrosine kinase domain is known to be associated with a number of genetic aberrations including deletions, insertions, and single nucleotide polymorphism. TKIs targeting EGFR, including gefitinib and erlotinib, have become the standard first-line therapies for patients with advanced non-small cell lung cancer (NSCLC) who harbour EGFR mutations most often in exons 18-21. The objective of the present study was to explore the EGFR mutational status of a population of lung cancer patients in northern India and evaluate the correlation with clinical characteristics.

      Methods
      Of the 105 consecutive patients of adenocarcinoma of lung treated in our department between January 2011 and May 2013, information regarding mutational status of EGFR was available for 80 patients. We present the correlation of various clinical parameters with EGFR mutational status for this group of patients. EGFR testing was done on the available biopsy material using a PCR based method.

      Results
      EGFR mutation status was known in 80 patients with adenocarcinoma lung. Their median age at presentation was 61.5 years with a range of 27 to 87 years. Thirty six (45%) patients were younger than 60 years. The male to female ratio was 2.6:1. The most common biopsy sites, in descending order were: lung mass- 56 (70%), pleura -13 (16%), lymph node – 06 (7.5%), liver- 03 (3.7%) and bone- 02 (2.5%),. All but 2 patients had stage IIIB or IV adenocarcinoma lung. The frequent sites of metastases were- bones (31%), brain (24%), hepatic (14%), adrenals (11%) and contralateral lung (5%). EGFR mutations were detected in twenty two (27.5%) patients. Among the mutant positive cases, the deletions in exon 19 (47%) and exon 21(38%) were most predominant. Out of the entire cohort (N=80), thirty seven (46%) patients had been smokers. Nine (41%) of the mutant patients had history of smoking.

      Conclusion
      Earlier published data from India had reported an incidence of 51.8% in a group of 220 patients of NSCLC who had been tested for EGFR mutations. At 27.5%, the rate of mutations in our group of patients is lower than that reported in the earlier publication from India. However, this is still higher than the prevalence reported in western literature. The proportion of smokers in the population with EGFR mutations was higher than that reported in other studies (41% in this study vs 22% in a study of Chinese lung cancer patients). This may be on account of retrospective analysis of a smaller sample size and selection bias in subjecting patients to EGFR testing. A prospectively designed trial incorporating a larger population of patients correlating clinical, radiological and other pathological features shall be required to answer various questions linked to EGFR mutational status in lung cancer patients particularly in the Indian sub-continent.