Factors that Predict Clinical Benefit of EGFR TKI Therapy in Patients with EGFR Wild-Type Lung Adenocarcinoma

Epidermal growth factor receptor ( ) mutations in non-small cell lung cancers have emerged as key predictive biomarkers in EGFR tyrosine kinase inhibitor (TKI) treatment. However, a few patients with wild-type also respond to EGFR TKIs. This study investigated the factors predicting successful EGFR...

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Bibliographic Details
Published in:Tuberculosis and respiratory diseases 2019, 82(1), 376, pp.62-70
Main Authors: Kim, Seo Yun, Myung, Jae Kyung, Kim, Hye Ryoun, Na, Im Il, Koh, Jae Soo, Baek, Hee Jong, Kim, Cheol Hyeon
Format: Article
Language:English
Subjects:
adenocarcinoma
epidermal growth factor
lung neoplasms
Original
receptor
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Summary:Epidermal growth factor receptor ( ) mutations in non-small cell lung cancers have emerged as key predictive biomarkers in EGFR tyrosine kinase inhibitor (TKI) treatment. However, a few patients with wild-type also respond to EGFR TKIs. This study investigated the factors predicting successful EGFR TKI treatment in lung adenocarcinoma patients with wild-type . We examined 66 patients diagnosed with lung adenocarcinoma carrying wide-type who were treated with EGFR TKIs. The gene copy number was assessed by silver hybridization (SISH). We evaluated the clinical factors and gene copy numbers that are associated with a favorable clinical response to EGFR TKIs. The objective response rate was 12.1%, while the disease control rate was 40.9%. EGFR SISH analysis was feasible in 23 cases. Twelve patients tested SISH-positive, and 11 were SISH-negative, with no significant difference in tumor response and survival between SISH-positive and -negative patients. The overall median progression-free survival (PFS) and overall survival (OS) of 66 patients were 2.1 months and 9.7 months, respectively. Female sex and Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0-1 were independent predictors of PFS. ECOG PS 0-1 and a low tumor burden of extrathoracic metastasis were independent predictors of good OS. Factors such as good PS, female sex, and low tumor burden may predict favorable outcomes following EGFR TKI therapy in patients with wild-type lung adenocarcinoma. However, gene copy number was not predictive of survival.
ISSN:1738-3536
2005-6184
DOI:10.4046/trd.2018.0004