EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors.
- Author:
Jiyoul YANG
1
;
Ok Jun LEE
;
Seung Myoung SON
;
Chang Gok WOO
;
Yusook JEONG
;
Yaewon YANG
;
Jihyun KWON
;
Ki Hyeong LEE
;
Hye Sook HAN
Author Information
- Publication Type:Original Article
- Keywords: Epidermal growth factor receptor; Lung adenocarcinoma; Pleural effusion; Tyrosine kinase inhibitor
- MeSH: Adenocarcinoma; Constriction; Diagnosis; Disease-Free Survival; Humans; Lung Neoplasms; Lung*; Pleural Effusion; Pleural Effusion, Malignant*; Protein-Tyrosine Kinases*; Receptor, Epidermal Growth Factor; Retrospective Studies; Tyrosine*
- From:Cancer Research and Treatment 2018;50(3):908-916
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Malignant pleural effusions (MPEs) are often observed in lung cancer, particularly adenocarcinoma. The aim of this study was to investigate epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma-associated MPEs (LA-MPEs) and its correlation with efficacy of EGFR tyrosine kinase inhibitor (TKI) therapy. MATERIALS AND METHODS: Samples comprised 40 cell blocks of pathologically-confirmed LA-MPEs collected before the start of EGFR TKI therapy. EGFR mutation status was re-evaluated by peptide nucleic acid clamping and the clinical outcomes of EGFR TKI-treated patients were analyzed retrospectively. RESULTS: EGFR mutations were detected in 72.5% of LA-MPE cell blocks (29/40). The median progression-free survival for patients with EGFR mutations in LA-MPEs was better than that for patients with wild-type EGFR (7.33 months vs. 2.07 months; hazard ratio, 0.486; 95% confidence interval, 0.206 to 1.144; p=0.032). The objective response rate (ORR) of 26 patients with EGFR mutations in LA-MPEs among the 36 patients with measurable lesions was 80.8%, while the ORR of the 10 patients with wild-type EGFR in LA-MPEs was 10% (p < 0.001). Among the 26 patients with EGFR mutations in LA-MPEs, the ORR of target lesions and LA-MPEs were 88.5% and 61.5%, respectively (p=0.026). CONCLUSION: EGFR mutation status in cell blocks of LA-MPEs confirmed by pathologic diagnosis is highly predictive of EGFR TKI efficacy. For patients with EGFR mutations in LA-MPEs, the response to EGFR TKIs seems to be worse for pleural effusions than for solid tumors.
