Prevalence of EGFR Mutations and Clinico-Pathological Characteristics of Chilean Lung Cancer Patients

Abstract

Background: Lung cancer (LC) is the second leading cause of cancer death in Chile, causing >3,000 deaths every year. Epidemiological LC data in Chile is scarce and scattered. Here, we aimed to quantify the prevalence of Epidermal Growth Factor Receptor (EGFR) gene mutations in a Chilean cancer center. These data may identify individuals that could benefit from targeted therapies such as Tyrosine Kinase Inhibitors (TKIs). Methods: A total of 1,405 Biopsies from 1,381 LC patients were retrospectively analyzed retrieving clinical data from EGFR mutants including age, gender, histological type, smoking habits and type of EGFR mutation. We also analyzed overall survival (OS) rates. Results: From all patients 21.7% had clinically relevant EGFR mutations, and a median age at diagnosis of 65 years. Most were female (64%), classified as adenocarcinomas (94.5%), and non-smokers/light smokers (93.1%). The most prevalent mutation was exon-19 deletions (50.6%) followed by Leucine-to Arginine 858; OS was 15 months. Clinical follow-up information was available for 83 patients. The use of TKIs in these patients significantly improved OS. Conclusion: The prevalence of EGFR mutations in the studied population was 21.7%, comparable to other countries in Latin America. The most frequent EGFR mutation was exon-19 deletion, OS in this group was 15 months, and TKIs significantly improved OS.

The relation between epidermal growth factor receptor mutations profiles and smoking patterns in patients with lung adenocarcinoma: A cross‐sectional study

“…Following the identification of activating EGFR mutations in a specific subgroup of NSCLC patients, targeted therapies such as TKI have emerged as highly effective treatments 7,28 28 29 .…”

“… 25 , 26 , 27 Following the identification of activating EGFR mutations in a specific subgroup of NSCLC patients, targeted therapies such as TKI have emerged as highly effective treatments. 7 , 28 The use of anti‐EGFR TKIs has greatly improved patients' quality of life and extended their overall survival by approximately 12 months. 28 Nonetheless, not all EGFR mutations are sensitive to TKIs.…”

Cáncer pulmonar: caracterización, estadificación y supervivencia en una cohorte de una década en un hospital del sistema público de salud de Chile

“…El descubrimiento de mutaciones conductoras en cáncer pulmonar ha permitido el desarrollo de terapia molecularmente dirigida a tales targets, obteniendo en general resultados al menos equiparables en supervivencia, menor perfil de efectos adversos y una mejor calidad de vida versus la quimioterapia convencional 40 . Las mutaciones conductoras son más frecuentes en adenocarcinomas y en nuestro centro se encontró una positividad, cuando se realizó el estudio, a EGFR de 20,7%, siendo muy similar a 21,7% reportado por otro estudio nacional reciente 41 .…”

“…Además, hemos analizado la supervivencia estimada de un subgrupo específico de pacientes que recibieron terapia target versus quimioterapia o cuidados paliativos exclusivamente en el Estadio IV, a fin de obtener una muestra suficiente para el análisis. Destacamos que las medianas de supervivencia estimada fueron similares a lo descrito internacionalmente para este subgrupo de pacientes [41][42][43] . Es importante señalar que el uso de estos tratamientos beneficia igualmente a pacientes con cáncer pulmonar avanzado no metastásico 42 .…”

Geographic differences in lung cancer: focus on carcinogens, genetic predisposition, and molecular epidemiology

“…The prevalence of EGFR somatic mutations in lung adenocarcinomas varies significantly across countries: from 14% in Argentina and 18% in Uruguay, 22% in Chile, 25% in Brazil and Colombia, 27% in Panama, 31% in Costa Rica or 34% in Mexico to 51% in Peru. 51 , 54 – 56 Notably, the prevalence of EGFR mutations in Argentina and Uruguay is like in Spain, potentially linked to the predominance of Spanish immigration and European ancestry. On the other hand, in other countries where the preponderance of Native and African American ancestry predominates, the higher prevalence of EGFR mutations might be related to distinct ethnic and ancestry patterns.…”