Open AccessImpact of EGFR Mutation Detection Methods on the Efficacy of Erlotinib in Patients with Advanced EGFR-Wild Type Lung Adenocarcinoma
Author(s) -
JengSen Tseng,
ChihLiang Wang,
MingShyan Huang,
ChungYu Chen,
Chung-Yi Chang,
TsungYing Yang,
Chi-Ren Tsai,
KunChieh Chen,
Kuo-Hsuan Hsu,
Meen-Hsin Tsai,
ShanFu Yu,
KangYi Su,
ChihWei Wu,
ChengTa Yang,
YuhMin Chen,
GeeChen Chang
Publication year - 2014
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0107160
Subject(s) - erlotinib , adenocarcinoma , epidermal growth factor receptor , medicine , lung cancer , oncology , lung , adenocarcinoma of the lung , erlotinib hydrochloride , gastroenterology , cancer
Methods used for epidermal growth factor receptor (EGFR) mutation testing vary widely. The impact of detection methods on the rates of response to EGFR-tyrosine kinase inhibitors (TKIs) in EGFR -wild type (wt) lung adenocarcinoma patients is unknown. Methods We recruited the Group-I patients to evaluate the efficacy of erlotinib in patients with EGFR -wt lung adenocarcinoma by either direct sequencing (DS) or mutant type-specific sensitive (MtS) methods in six medical centers in Taiwan. Cross recheck of EGFR mutations was performed in patients who achieved objective response to erlotinib and had adequate specimens. The independent Group-II lung adenocarcinoma patients whose EGFR mutation status determined by DS were recruited to evaluate the potential limitations of three MtS methods. Results In Group-I analysis, 38 of 261 EGFR -wt patients (14.6%) achieved partial response to erlotinib treatment. Nineteen patients (50.0%) had adequate specimens for cross recheck of EGFR mutations and 10 of them (52.6%) had changes in EGFR mutation status, 5 in 10 by DS and 5 in 9 by MtS methods originally. In Group-II analysis, 598 of 996 lung adenocarcinoma patients (60.0%) had detectable EGFR mutations. The accuracy rates of the three MtS methods, MALDI-TOF MS, Scorpions ARMS and Cobas, were 87.8%, 86.8% and 85.8%, respectively. Conclusions A significant portion of the erlotinib responses in EGFR -wt lung adenocarcinoma patients were related to the limitations of detection methods, not only DS but also MtS methods with similar percentages. Prospective studies are needed to define the proper strategy for EGFR mutation testing.