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Our aim was to investigate the clinical and pathologic characteristics of the epidermal growth factor receptor ( EGFR ) exon 18 mutations in East Asian lung adenocarcinomas patients. A total of 1,201 lung adenocarcinomas were analyzed for mutation in  EGFR . Clinical and pathologic characteristics of patients with  EGFR  exon 18 mutations were compared with those who harbored classic activating mutations (exon 19 deletions and the L858R point mutation). The mutations in  EGFR  exon 18 were observed in 2.8% of 1,201 lung adenocarcinomas and 4.6% of patients with  EGFR  mutations. Patients with a single  EGFR  exon of 18 mutations had a worse overall survival than those harboring the complex  EGFR  exon of 18 mutations ( p  = 0.002) or those with classic activating mutations ( p  = 0.014). Four of five patients with  EGFR  exon 18 mutations showed objective response to the EGFR-TKI therapies after disease recurrence. Our results demonstrated that single  EGFR  exon 18 mutations may be an indicator of poor prognosis compared with complex  EGFR  exon 18 mutations or classic mutations. Furthermore, the results of the current study will be helpful for decision-making in the treatment of patients with  EGFR  exon 18 mutations.

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EGFR Exon 18 Mutations in East Asian Patients with Lung Adenocarcinomas: A Comprehensive Investigation of Prevalence, Clinicopathologic Characteristics and Prognosis