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2018, Number 2

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Rev Sanid Milit Mex 2018; 72 (2)

Survival of patients with pulmonary adenocarcinoma and mutation in the epidermal growth factor receptor

Martínez TWR, Pérez ZF, Torres ACG

Language: Spanish
References: 27
Page: 118-124
PDF size: 249.18 Kb.


ABSTRACT

Introduction: Pulmonary carcinoma is the leading cause of cancer deaths in the world; the expression of the epidermal growth factor receptor in lung carcinoma tissue occurs in the adenocarcinoma lineage. The use of tyrosine kinase inhibitors that act on said receptor has increased survival beyond two years in mutated EGFR patients. Objective: To know the effect of tyrosine kinase inhibitors in the survival of patients with pulmonary adenocarcinoma, mutated EGFR. Material and methods: An observational, analytical, retrospective, transversal study was conducted over a period of two years (2013 to 2015), including patients with a confirmed diagnosis of lung cancer and the presence of the mutated EGFR performed by FISH (fluorescent in situ hybridization). The survival was evaluated by Kaplan-Meier test/Cox regression, considering a statistical significance associated with a p ≤ 0.005. Results: Thirteen patients were included; their average age was 66.77 ± 9.356 years, with a median of 67 years; 46.2% were women and 53.8% men. The most common type of deletion was of exon 19 (in 61.5%); the second was of L858R (in 38.5%). Three (23%) patients were smokers and 10 (77%) reported not to be; eight (61%) presented deletion of exon 19 and five (39%) deletion of L858R. By the end of the study, six patients had survived (46%) and seven died (54%). The Kaplan-Meier method showed 21.95 months of survival (95% CI 17.3-26.61).


REFERENCES

  1. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2012. Int J Cancer. 2010; 127 (12): 2893-2917.

  2. Fernández CS, León AG, Herrera TM. Perfil epidemiológico de los tumores malignos en México. Dirección General de Epidemiología, Secretaría de Salud; 2013. Disponible en: www.epidemiología.salud.gob.mx.

  3. Organización Mundial de la Salud: Cáncer. 2015. Disponible en: www.who.int/topics/cancer/es.

  4. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med. 2002; 346 (2): 92-98.

  5. Gazdar AF. Activating and resistance mutations of EGFR in non-small-cell lung cancer: Role in clinical response to EGFR tyrosine kinase inhibitors. Oncogene. 2009; 28 (Suppl 1): S24-S31.

  6. Li D, Ambrogio L, Shimamura T, Kubo S, Takahashi M, Chirieac LR et al. BIBW2992, an irreversible EGFR/HER2 inhibitor highly effective in preclinical lung cancer models. Oncogene. 2008; 27 (34): 4702-4711.

  7. Sato M, Shames DS, Gazdar AF, Minna JD. A translational view of the molecular pathogenesis of lung cancer. J Thorac Oncol. 2007; 2 (4): 327-343.

  8. Sharma SV, Bell DW, Settleman J, Haber DA. Epidermal growth factor receptor mutations in lung cancer. Nat Rev Cancer. 2007; 7 (3): 169-181.

  9. Rosell R, Moran T, Queralt C, Porta R, Cardenal F, Camps C et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med. 2009; 361 (10): 958-967.

  10. Bean J, Brennan C, Shih JY, Riely G, Viale A, Wang L et al. MET amplification occurs with or without T790M mutations in EGFR mutant lung tumors with acquired resistance to gefitinib or erlotinib. Proc Natl Acad Sci USA. 2007; 104 (52): 20932-7.

  11. Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009; 361 (10): 947-957.

  12. Mitsudomi T, Morita S, Yatabe Y, Negoro S, Okamoto I, Tsurutani J et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol. 2010; 11: 121-128.

  13. Maemondo M, Inoue A, Kobayashi K, Sugawara S, Oizumi S, Isobe H et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med. 2010; 362 (25): 2380-2388.

  14. Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982; 5 (6): 649-655.

  15. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009; 45 (2): 228-247.

  16. Solca F, Dahl C, Zoephel A et al. Target binding properties and cellular activity of afatinib (BIBW 2992), an irreversible ErbB family blocker. J Pharmacol Exp Ther. 2012; 343: 342-350.

  17. Lee JS, Park K, Kim SW et al. A randomized phase III study of gefitinib (IRESSA™) versus standard chemotherapy (gemcitabine plus cisplatin) as a first line treatment for never-smokers with advanced or metastatic adenocarcinoma of the lung. J Thorac Oncol. 2009; 4 (Suppl 1): S283-284. (Abstr PRS.4).

  18. Yang JC, Shih JY, Su WC, Hsia TC, Tsai CM, Ou SH et al. Afatinib for patients with lung adenocarcinoma and epidermal growth factor receptor mutations (LUX-Lung 2): a phase 2 trial. Lancet Oncol. 2012; 13 (5): 539-548.

  19. Thatcher N, Chang A, Parikh P, Rodrigues PJ, Ciuleanu T, von Pawel J et al. Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: Results from a randomised, placebo controlled, multicentre study (Iressa Survival Evaluation in Lung Cancer). Lancet. 2005; 366 (9496): 1527-1537.

  20. Fukuoka M, Wu YL, Thongprasert S, Sunpaweravong P, Leong SS, Sriuranpong V et al. Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non-small-cell lung cancer in Asia (IPASS). J Clin Oncol. 2011; 29 (21): 2866-2874.

  21. Lynch TJ, Bell DW, Sordella R, Gurubhagavatula S, Okimoto RA, Brannigan BW et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of nonsmall-cell lung cancer to gefitinib. N Engl J Med. 2004; 350 (21): 2129-2139.

  22. Zhou C, Wu YL, Chen G, Feng J, Liu XQ, Wang C et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2011; 12 (8): 735-742.

  23. Rosell R, Carcereny E, Gervais R, Vergnenegre A, Massuti B, Felip E et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol. 2012; 13 (3): 239-246.

  24. Yang JC, Hirsh V, Schuler M, Yamamoto N, O’Byrne KJ, Mok TS et al. Symptom control and quality of life in LUX-Lung 3: a phase III study of afatinib or cisplatin/pemetrexed in patients with advanced lung adenocarcinoma with EGFR mutations. J Clin Oncol. 2013; 31 (27): 3342-3350.

  25. Azzoli CG, Temin S, Aliff T, Baker S Jr, Brahmer J, Johnson DH et al. 2011 Focused update of 2009 American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV non-small-cell lung cancer. J Clin Oncol. 2011; 29 (28): 3825-3831.

  26. Peters S, Adjei AA, Gridelli C, Reck M, Kerr K, Felip E et al. Metastatic non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012; 23 (Suppl 7): vii56-64.

  27. Campos-Parra, Cruz-Rico, Arrieta O. Genotipificación en cáncer de pulmón de células no pequeñas. GAMO. 2012; 11 (1): 35-44.




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