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Is EGFR gene sequencing useful in squamous cell lung cancer-
Lung Cancer - Non-Small Cell Metastatic
Session Type and Session Title:
This abstract will not be presented at the 2012 ASCO Annual Meeting but has been published in conjunction with the meeting.
J Clin Oncol 30, 2012 (suppl; abstr e18111)
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy are designated with a caret symbol (^).
Background: NCCN guidelines for NSCLC, currently do not recommend EGFR gene mutation study in squamous cell carcinoma (SLC), based on its low frequency of mutation (only 3% of SLC) and on the assumed low predictive value of these mutations in this population. Aim: To evaluate EGFR mutation rate in SLC, as well as response to treatment with erlotinib (disease control and survival) of patients with SLC, according to the mutational status of the EGFR gene. Methods: Revision of clinical and pathological features of patients with SLC for which we had performed EGFR sequencing. In the group of SLC patients with stage IIIB//IV at diagnosis treated with erlotinib 150 mg/day after at least one line of chemotherapy, comparison of response to erlotinib – disease control, overall survival (OS) and survival after the introduction of erlotinib (SE) – among the mutated and wild-type EGFR was performed. Results: Between January 2006 and December 2011, 98 patients with SLC were subject to EGFR sequencing – 89 males, 9 females; mean age 66.2 ±11.1 years; 82 smokers or former smokers. EGFR mutation was found in 11 patients (11.2%), 10 of which were male. Of these 98 patients, 22 were treated with erlotinib. 18 patients were in stage IIIB/IV at diagnosis and 5 had mutated EGFR. Of these 18 patients, median OS was 21.52 months and median SE was 5.5 months. Disease control was achieved in 6 (33%) patients. Median OS was 27.45 months in EGFR mutated SLC, against 19.5 in wild-type (p<0.05). Median SE was 13.5 months in mutated EGFR against 4.3 months in the wild-type (p<0.05). EGFR mutation was related with disease control – OR 22 (95% CI 1.53-314.3). Conclusions: In spite of the small sample size, this study shows that EGFR mutation rate of SLC in a Caucasian population is not insignificant and its presence is associated to a greater disease control and longer survival, as it has been described to lung adenocarcinoma.