Prevalence and Patterns of EGFR Mutations in Non-small Cell Lung Cancer in the Middle East and North Africa

Abstract

Objectives This study aims to analyze the prevalence and spectrum of epidermal growth factor receptor (EGFR) mutations within the Middle East and North Africa region, compare the findings to other parts of the world, and explore the geographic disparities of EGFR mutations across the region. Methods We conducted a literature search using the terms “[EGFR] AND [mutation] AND [Non-Small Cell Lung Cancer] AND [Middle East OR North Africa]”, using PubMed, Science Direct, Web of science, Embase, Scopus, and Google scholar. Results A total of 15 eligible studies were included and 6122 patients with non-small cell lung cancer (NSCLC) were analyzed. Male patients were predominant in all of the considered studies, accounting for 70.4%. Of the included patients, 65.6% were smokers and 88.3% had been diagnosed with adenocarcinoma. Overall, EGFR mutations prevalence was 17.2%. In the Middle East, the reported frequency was 16.5%, ranging from 11.3% in Lebanon to 29.7% in the Gulf region. In North Africa, the prevalence of EGFR mutations was 18%, ranging from 17.5% in Egypt to 21.5% in Morocco. The most prevalent mutations were the exon 19 deletions (46.7%) followed by exon 21 substitutions (31.1%). Exon 20 alterations were detected in 10.8% of the analyzed cases, whereas exon 18 mutations were reported in 3.4% of the EGFR-mutated patients. There was 1.1% of patients that had concurrent EGFR mutations. Overall, EGFR mutation prevalence was higher in females [females vs males: 29.7% vs 5.9%, P<.001], non-smokers [non-smokers vs smokers: 31.3% vs 9.6%, P<.001], and patients with adenocarcinoma [adenocarcinoma vs non-adenocarcinoma: 18.8% vs 6.5%, P<.001]. Conclusion EGFR mutation prevalence among the Middle East and North Africa populations is slightly higher than that seen in NSCLC patients of Caucasian ethnicity but is lower than that identified in Asian NSCLC patients. The distribution of these mutations varies considerably throughout the region.

A retrospective, descriptive analysis identifying non‑small cell lung cancer molecular markers

“…In the population of the present study, the mutation frequency was lower than in the East Asian study but higher than the reported frequencies in the European study ( 14 , 15 ). The results obtained in the present study were similar to a recent systematic review, which revealed an overall prevalence of 17% for EGFR mutations in the Middle East and North African region; however, they reported significant variations within countries ranging from 11-30% ( 16 ). In the present study, EGFR mutations were significantly more frequent in non-smokers, with 22 out of 29 patients with EGFR positive mutations falling into this category.…”

“…In the present study, EGFR mutations were significantly more frequent in non-smokers, with 22 out of 29 patients with EGFR positive mutations falling into this category. These findings are well reported in a number of studies ( 16-18 ); in particular, the meta-analysis by Ren et al ( 18 ) which indicated that the odds ratio for EGFR mutation in non-smokers was 4.8 compared with smokers.…”

Investigating Common Mutations in Exon 20 and 21 of EGFR Gene in Lung Cancer Tumor Tissue of NSCLC Type

“…The EGFR gene, with chromosomal location 7p11.2 and 32 exons, has the most mutations related to lung cancer in exons 19 and 21 (18). Most of the known mutations in these exons have been of the deletion or substitution type (21).…”