Influence of EGFR mutational status on metastatic behavior in non squamous non small cell lung cancer

Abstract

Epidermal Growth Factor Receptor (EGFR) mutated Non Small Cell Lung Cancers (NSCLCs) are a molecularly subgroup of patients with peculiar clinic-pathological characteristics. Previous studies have suggested a possible interaction between oncogene status and metastatic behavior in non squamous NSCLCs with conflicting results. The aim of this study was to compare the different metastatic patterns, at baseline and during the course of the disease, in a cohort of 137 Caucasian patients with non-squamous NSCLC according to the EGFR mutational status and survival differences according to the different metastatic behavior. We observed unique metastatic distributions between EGFR-mutated and EGFR wild type non-squamous NSCLCs. These data support the hypothesis that tumor bio-molecular characteristics and genotype may influence the metastatic process in NSCLC and might help the development of enrichment strategies for tumor genotyping in these tumors, especially in the presence of limited tissue availability.

The role of EGFR mutation as a prognostic factor in survival after diagnosis of brain metastasis in non-small cell lung cancer: a systematic review and meta-analysis

“…Of the 18 included studies (encompassing a total of 4373 NSCLC patients with brain metastases), 3 had a prospective design [18, 26, 30] and 15 had a retrospective design [14–17, 19–25, 27–29, 31]. Nine included studies were from Asia [14, 15, 17, 18, 20, 24–26, 31], and 9 were from Europe or America [16, 19, 21–23, 27–30]. All studies were published between 2009 and 2017, and 41–1127 patients were included in each study.…”

“…All studies were published between 2009 and 2017, and 41–1127 patients were included in each study. Five studies included only patients with lung adenocarcinoma [14, 18, 20, 22, 26], while the other studies included various types of lung cancers [15–17, 19, 21, 23–25, 27–31]. The mean age of included patients ranged from 55.0–67.0 years, percentage male ranged from 28.3 to 66.2%, percentage smokers ranged from 21.9 to 77.4%, and percentage of patients receiving TKI ranged from 5.1 to 44.0%.…”

“…The mean age of included patients ranged from 55.0–67.0 years, percentage male ranged from 28.3 to 66.2%, percentage smokers ranged from 21.9 to 77.4%, and percentage of patients receiving TKI ranged from 5.1 to 44.0%. Study quality was assessed using the NOS, and 4 studies scored 8 [19, 20, 22, 23], 5 studies scored 7 [14–16, 25, 26], 5 studies scored 6 [21, 27, 28, 30, 31], and the remaining 4 studies scored 5 [17, 18, 24, 29]. The general characteristics of the included studies are presented in Table 1.…”

Correlation between EGFR mutation status and the incidence of brain metastases in patients with non-small cell lung cancer

“…The NOS was used to perform quality assessment on all 22 studies and 14 (17,18,(25)(26)(27)(28)30,(32)(33)(34)(35)(36)38,42) high-quality and 8 (16,19,29,31,37,(39)(40)(41) as low-quality.…”

“…Seven eligible trials (17,18,26,29,30,36,40) A random effect model was performed owing to high heterogeneity (P=0.001, I 2 =72.4%). Compared with EGFR wild type group, EGFR mutations group displayed a prolonged overall BMOS (HR =0.68; 95% CI, 0.47-0.98; P=0.038) ( Figure 4A).…”