Epidermal Growth Factor Receptor Mutations: Effect on Volume Doubling Time of Non–Small-Cell Lung Cancer Patients

Nakamura, Ryota; Inage, Yoshihisa; Tobita, Rika; Mori, Kazuko; Numata, Tomohiro; Yanai, Hidetoshi; Endo, Takeo; Ohtani, Haruo; Satoh, Hiroaki; Yuzawa, Kenji; Koizumi, Masao; Ueki, Hiroyuki

doi:10.1097/jto.0000000000000022

Cited by 27 publications

(17 citation statements)

References 28 publications

(41 reference statements)

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“…This is supported by a previous investigation of the volume doubling time (VDT) in incidentally detected symptom-free NSCLC. In the study, the VDT in the 33 adenocarcinoma patients with EGFR mutations was longer than that in 36 adenocarcinoma patients with wild-type EGFR (676 vs. 200 days; P = 0.014) [28]. Several studies have suggested that lung cancer with a VDT of more than 400 days indicates an indolent tumor [29, 30].…”

Section: Discussionmentioning

confidence: 99%

The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas

et al. 2016

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BackgroundThe prognostic role of epidermal growth factor receptor (EGFR) mutations in patients with lung adenocarcinomas remains controversial and the association between EGFR mutations and stage at the time of the initial diagnosis is debatable. In this study, we evaluated the association of EGFR mutations with stage at diagnosis in lung adenocarcinomas.Materials and MethodsWe retrospectively analyzed 1004 consecutive patients who were diagnosed with lung adenocarcinomas and tested for EGFR mutations between June 2011 and December 2014.ResultsEGFR mutations were detected in 49.2% of 1004 patients with lung adenocarcinomas. In multivariable analysis, EGFR mutations were significantly associated with early stage disease (stage I to II) at diagnosis (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.49–0.87; P = 0.003). When adjusted for age, sex, smoking status, and screening, the adjusted proportion of EGFR mutations significantly decreased according to stage. The adjusted proportions of EGFR mutations were 57.6% (95% CI, 51.7%–63.3%) for stage I, 47.9% (95% CI, 36.9%–59.0%) for stage II, 47.5% (95% CI, 39.6%–55.5%) for stage III, and 43.4% (95% CI, 38.3%–48.6%) for stage IV (P = 0.0082).ConclusionsThe presence of EGFR mutations is significantly associated with early stage disease at initial diagnosis in lung adenocarcinomas after adjusting for age, sex, smoking status, and screening. This finding implies that EGFR mutations may play a role as a positive prognostic marker.

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Section: Discussionmentioning

confidence: 99%

The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas

et al. 2016

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“… 7 A recent epidemiology study of EGFR mutations in Asian patients with advanced NSCLC showed that the mutation frequency was 43% in Asian patients, 52% of those being Chinese patients. 8 Most recently, Nakamura et al 9 reported that positive EGFR mutation status may be associated with longer volume doubling time in NSCLC patients. In our study, we found that P-LC patients have significant higher incidence of EGFR mutations, independent of sex, histological type, and smoking history.…”

Section: Introductionmentioning

confidence: 99%

High Incidence of EGFR Mutations in Pneumonic-Type Non-Small Cell Lung Cancer

et al. 2015

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To retrospectively identify computed tomography (CT) features that correlate with epidermal growth factor receptor (EGFR) mutation in surgically resected pneumonic-type lung cancer (P-LC).A total of 953 consecutive patients with surgically resected lung cancer in the First Affiliated Hospital of Guangzhou Medical University from August 2011 to August 2013 were studied. The CT manifestations were reevaluated independently by 2 radiologists. The presence of pneumonic-type consolidation with pathological confirmed non-small lung cancer (NSCLC) was defined as P-LC. EGFR mutation was determined by direct DNA sequencing or amplification refractory mutation system-PCR. EGFR mutation rates as well as clinical and pathological manifestations between P-LC and control lung cancer patients were compared.P-LC was diagnosed in 85 patients. Among these patients, 82 were adenocarcinoma (including 78 cases of invasive adenocarcinoma and 4 cases of microinvasive adenocarcinoma), 2 were squamous carcinoma and 1 was other type. P-LC occurred more frequently in female (58.8% vs 37.1%, P < 0.01), nonsmoking (76.5% vs 56.5%, P = 0.001) and adenocarcinoma (58.8% vs 37.1%, P < 0.01) patients. Moreover, EGFR mutations were found in 39 of 52 P-LC patients (75%) and 263 of 542 non-P-LC NSCLC patients (48.5%). However, no difference was found on the mutation sites of EGFR. Histological type, sex, and radiological manifestations (P-LC vs non-P-LC) but not smoking or sequencing method can be served as the independent predictor of EGFR mutations.P-LC patients showed a significant higher incidence of EGFR mutations, which was independent of sex, histological type, and smoking history. The patients with imaging manifestation of pneumonic-type consolidation are highly suggested to perform EGFR mutation analysis to guide the sequential treatment.

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“…Nakamura et al (12) firstly studied the relationship between VDT and EGFR mutation by retrospectively reviewing 102 NSCLCs and found that the VDTs of patients with EGFR mutations (median 676 days) were longer than those without EGFR mutations (median 139 days).…”

Section: Discussionmentioning

confidence: 99%

“…Nakamura et al firstly described the possible relationships between VDT and EGFR mutation status, finding positive EGFR mutation status may be associated with longer VDT. However, the major limitation of Nakamura's study is the VDT calculation depended on conventional measurement methods and possible statistical bias could have been caused by squamous-cell carcinoma (12).…”

Section: Introductionmentioning

confidence: 99%

Volume doubling time of lung adenocarcinomas considering epidermal growth factor receptor mutation status of exon 19 and 21: three-dimensional volumetric evaluation

et al. 2017

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Background: The current study was to investigate the volume doubling time (VDT) of lung adenocarcinomas considering epidermal growth factor receptor (EGFR) mutation status of exon 19 and 21, when compared with EGFR wide type.Methods: Eighty-eight patients with pathologically proven adenocarcinomas, which underwent two or more computed tomography (CT) scans spared by 25 or more days, were included. EGFR mutations at exons 19 and 21 were determined using amplification refractory mutation system and all patients were divided into three groups-EGFR wide type group, EGFR mutation in exon 19 and 21 groups. Threedimensional manual segmentations for all tumors were performed on first and latest follow-up CT scans; subsequently, VDTs were calculated and compared among three groups. Clinicopathoradiologic characters were also collected for subgroup analysis.Results: EGFR mutations occurred in 49 (55.7%) patients, 19 in exon 19 and 30 in exon 21, respectively.The median VDT of all patients (33 men, 55 women; median age, 62 years) was 214 days (range, −4,092 to 10,920 days). Highly differentiated adenocarcinomas (median, 408 days) demonstrated longer VDT than those moderately (median, 172 days) or poorly (median, 144 days) differentiated (P=0.04). The VDT distribution was similar among EGFR wide type group (median, 207 days), EGFR mutation in exon 19 group (median, 288 days) and exon 21 group (median, 144 days) (P=0.21). In subgroup analysis, the median VDT of adenocarcinomas with EGFR mutation in exon 19 was longer than that of EGFR wide type for males (P=0.03) or patients without spiculation sign in chest CT (P=0.04). Totally 24 adenocarcinomas presented negative VDTs, most of which tended to be stable. Positive VDT values were used for all median description.Conclusions: Overall VDT of lung adenocarcinomas seems not affected by EGFR mutation status.Researches with large population are warranted for further study.

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Epidermal Growth Factor Receptor Mutations: Effect on Volume Doubling Time of Non–Small-Cell Lung Cancer Patients

Cited by 27 publications

References 28 publications

The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas

The Association of EGFR Mutations with Stage at Diagnosis in Lung Adenocarcinomas

High Incidence of EGFR Mutations in Pneumonic-Type Non-Small Cell Lung Cancer

Volume doubling time of lung adenocarcinomas considering epidermal growth factor receptor mutation status of exon 19 and 21: three-dimensional volumetric evaluation

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