Updated Frequency of EGFR and KRAS Mutations in NonSmall-Cell Lung Cancer in Latin America The Latin-American Consortium for the Investigation of Lung Cancer (CLICaP)
Updated Frequency of EGFR and KRAS Mutations in NonSmall-Cell Lung Cancer in Latin America The Latin-American Consortium for the Investigation of Lung Cancer (CLICaP)
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DOI：
10.1097/jto.0000000000000481
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发表时间：
2015-05-01
影响因子：
20.4
通讯作者：
Cuello, Mauricio
中科院分区：
文献类型：
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作者：
Arrieta, Oscar;Cardona, Andres F.;Cuello, Mauricio
前言：此前，我们报道了拉丁美洲非小细胞肺癌(NSCLC)患者表皮生长因子受体(EGFR)和KRAS基因突变的频率。在亚洲人群(40%)和高加索人群(15%)之间发现了EGFR突变频率。方法：对来自阿根廷(1713例)、墨西哥(1417例)、哥伦比亚(1939例)、秘鲁(393例)、巴拿马(174例)和哥斯达黎加(102例)的5738例非小细胞肺癌患者进行了EGFR和KRAS基因分型。结果：患者年龄中位数为62.2+/-12.3岁，53.5%为女性，46.7%有吸烟史，95.2%有腺癌组织学史。EGFR突变频率为26.0%(95%可信区间24.9-27.1；阿根廷14.4%[12.8-15.6]；墨西哥34.3%[31.9-36.7]；哥伦比亚24.7%[22.8-26.6]；秘鲁51.1%[46.2-55.9]；巴拿马27.3[20.7-33.9]；哥斯达黎加31.4%[22.4-40.4])。KRAS基因突变频率为14.0%(9.1~18.9)。在腺癌患者中，表皮生长因子受体基因突变与性别(女性30.7%对男性18.4%；p<；0.001)、不吸烟状态(27.4%对17.1%，p<；0.001)、种族(混血族/土著，35.3%对高加索人，13.7%，p<；0.001)以及没有KRAS突变(38.1%对4.7%；p<；0.001)独立相关。对EGFR酪氨酸激酶抑制剂的总有效率为60.6%(95%CI，52-69)，中位无进展生存期和总生存期分别为15.9(95%CI，12.420.6)和32个月(95%CI，26.5-37.6)。结论：我们的研究结果支持拉丁美洲NSCLC的遗传异质性，证实了EGFR突变的频率介于亚洲和高加索人群之间。
Introduction: Previously, we reported the frequency of epidermal growth factor receptor (EGFR) and KRAS mutations in nonsmall-cell lung cancer (NSCLC) patients in Latin America. The EGFR mutation frequency was found between Asian (40%) and Caucasian (15%) populations. Here, we report the updated distribution of NSCLC mutations.Methods: A total of 5738 samples from NSCLC patients from Argentina (1713), Mexico (1417), Colombia (1939), Peru (393), Panama (174), and Costa Rica (102) were genotyped for EGFR and KRAS.Results: The median patient age was 62.2 +/- 12.3 years; 53.5% were women, 46.7% had a history of smoking, and 95.2% had adenocarcinoma histology. The frequency of EGFR mutations was 26.0% (95% confidence interval [CI], 24.9-27.1; Argentina, 14.4% [12.8-15.6]; Mexico, 34.3% [31.9-36.7]; Colombia, 24.7% [22.8-26.6]; Peru, 51.1% [46.2-55.9]; Panama, 27.3 [20.7-33.9]; and Costa Rica, 31.4% [22.4-40.4]). The frequency of KRAS mutations was 14.0% (9.1-18.9). In patients with adenocarcinoma, EGFR mutations were independently associated with gender (30.7% females vs. 18.4% males; p < 0.001), nonsmoker status (27.4% vs. 17.1%, p < 0.001), ethnicity (mestizo/indigenous, 35.3% vs. Caucasian, 13.7%, p < 0.001), and the absence of KRAS mutation (38.1% vs. 4.7%; p < 0.001). The overall response rate to EGFR tyrosine kinase inhibitors was 60.6% (95% CI, 52-69), with a median progression-free survival and overall survival of 15.9 (95% CI, 12.420.6) and 32 months (95% CI, 26.5-37.6), respectively.Conclusion: Our findings support the genetic heterogeneity of NSCLC in Latin America, confirming that the frequency of EGFR mutations is intermediate between that observed in the Asian and Caucasian populations.