EGFR mutation in squamous cell carcinoma of the lung: does it carry the same connotation as in adenocarcinomas?
Authors Joshi A, Zanwar S, Noronha V, Patil VM, Chougule A, Kumar R, Janu A, Mahajan A, Kapoor A, Prabhash K
Received 21 October 2016
Accepted for publication 17 December 2016
Published 28 March 2017 Volume 2017:10 Pages 1859—1863
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 2
Editor who approved publication: Dr Tohru Yamada
Amit Joshi,1 Saurabh Zanwar,1 Vanita Noronha,1 Vijay M Patil,1 Anuradha Chougule,2 Rajiv Kumar,3 Amit Janu,4 Abhishek Mahajan,4 Akhil Kapoor,1 Kumar Prabhash1
1Department of Medical Oncology, Tata Memorial Hospital, 2Molecular Laboratory, Department of Medical Oncology, 3Department of Pathology, 4Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
Background: EGFR tyrosine kinase inhibitors (TKIs) have greatly improved the outcomes of EGFR mutation-positive adenocarcinomas of the lung. In contrast, the significance of EGFR mutation in metastatic squamous cell carcinoma (SCC) of the lung has been debated.
Methods: All patients with metastatic SCC who underwent EGFR mutation testing at our center from 2010 to 2015 were included for analysis. EGFR kinase domain mutations were tested using Taqman-based real-time polymerase chain reaction (PCR). Response assessment was done using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1. Kaplan–Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).
Results: EGFR mutation was detected in 29 out of 639 patients with SCC. Furthermore, 19 out of the 29 patients received TKIs at some point during their treatment. TKI therapy led to a partial response in 5 out of 19 patients and stable disease in 4 out of 19 patients. The median PFS of patients treated with TKIs was 5.0 months. The median OS of the whole EGFR-positive SCC cohort was 6.6 months. On univariate analysis, patients having received TKI therapy was the only factor associated with a significantly better OS of 13.48 months versus 2.58 months (P=0.000). On multivariate analysis, patients receiving TKI therapy, Eastern Cooperative Oncology Group–Performance Scale (ECOG-PS) score <2, EGFR exon 19 mutation and nonsmoking status were associated with significantly better OS.
Conclusion: EGFR mutation in SCC of the lung predicts a better outcome if the patient is given TKI, but it may be inferior to the outcomes seen in EGFR-positive adenocarcinomas treated with TKI.
Keywords: EGFR mutation, squamous cell carcinoma, SCC lung, TKI efficacy
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