Epidermal Growth Factor Receptor (EGFR) Gene Mutation Analysis in Adenocarcinoma of Lung, the First Report from Iran

Abstract

Background and Objective: Epidermal growth factor receptor (EGFR) gene mutation, especially in exons 18 to 21, is an important predictor of the response rate of lung adenocarcinoma to tyrosine kinase inhibitors. There are variable reports from Asian and European countries, as well as North America, about the frequency of the EGFR mutation in lung adenocarcinoma, yet molecular study about this incidence has been published from Iran. In this study, we investigated the frequency of this mutation in our center, which is the largest referral center in the south of country. This report will be the first published article about EGFR mutational analysis from Iran. Methods: During the study period (September 2011 till September 2016) i.e. 5 years, there have been 50 cases of pathologically-confirmed lung adenocarcinoma. These cases underwent mutational analysis for exons 18 to 21 of the EGFR gene by PCR and DNA sequencing. All demographic findings were also extracted from the patients’ charts and recorded. Results: There were 30 male and 20 female patients, with an average age of 58 years. The overall frequency of EGFR mutation was 28% (14 out of 50). The most common mutation was Del 19 (10 of 14, 71.4%), 3 mutations were found in exon 20 and one mutation was found in exon 21. EGFR mutations were more frequent in women than in men (30% versus 26.7%) and in nonsmokers than in smokers (37.9% versus 14.3%). Conclusion: Lung adenocarcinoma with EGFR mutation shows strong association with female non-smokers. Our results showed an intermediate frequency of this mutation, which was higher than results from Western countries and lower than most Asian countries.

Evaluation of Epidermal Growth Factor Receptor Gene Mutations in an Iranian Population with Non-Small Cell Lung Carcinoma

“…The substitution mutation of c.2253A > G was the rarest found in the present work, which accounted for up to 5.8% of all detected mutations. Similar to our results, an in-frame deletion was reported in exon 19 as the most common EGFR mutation comprising up to 71.4% of all mutations in lung adenocarcinoma patients (Shiraz, Iran) ( 18 ). Moreover, in our investigation, two main resistant EGFR -TKI mutations (exon 20 inserts and T790M) were not found that is to consistent with two previous studies conducted in Iran ( 17 , 18 ).…”

“…Furthermore, the frequencies and nature of driver mutations in NSCLC cases have been shown to be largely distinct, primarily based on ethnicity ( 16 ). Regarding Iran, as a highly multi-ethnic/racial country, there are several reports on the incidence of EGFR mutations in NSCLC patients ( 17 , 18 ). Therefore, evaluating the frequencies of EGFR mutations in different ethnicities in this country is essential.…”

Prevalence and Patterns of EGFR Mutations in Non-Small Cell Lung Cancer in the Middle East and North Africa: A Systematic Review

“…Original articles were identi ed from Jordan [19], Iran [20,21], Turkey [22][23][24][25][26], Bahrain [27], Iraq [29,30], Lebanon [31][32][33], Morocco [35][36][37], Tunisia [38][39][40], Egypt [41], and Algeria [42]. A multicenter prospective study from Levant (Lebanone, Syria, Palestine, Jordan, Iraq, and Egypt) [34] and a multisite retrospective study from Gulf region (Saudi Arabia, the United Arab Emirates and Qatar) were also identi ed and will part of our analysis [28].…”

“…Characteristics of the included studies. 24 eligible studies: 16 (66.6%) in the ME[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] and 8 (34.4%) in NA[35][36][37][38][39][40][41][42]. Overall, EGFR mutations were analyzed in 6544 patients with NSCLC [3610 (55.2%) in the ME and 2934 (44.8%) in NA].…”

“…Overall, EGFR exons 18 through 21 mutations were assessed in 19 out of the 24 considered studies in 86,1% (5635/6544) NSCLC patients: Jordan (1 study, 166 patients)[19], Iran (2 studies, 153 patients)[20,21],Turkey (3 studies, 1416 patients)[22,24,25], Bahrain (1 study, 65 patients)[27], the Gulf Region (1 study, 230 patients) [28], Iraq(2 study, 165 patients) …”