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Clinical predictors versus epidermal growth factor receptor mutation in gefitinib-treated non-small-cell lung cancer patients

Cited 32 time in Web of Science Cited 32 time in Scopus
Authors
Han, Sae-Won; Kim, Tae-You; Lee, Kyung-Hun; Hwang, Pil Gyu; Jeon, Yoon Kyung; Oh, Do-Youn; Lee, Se-Hoon; Kim, Dong-Wan; Im, Seock-Ah; Chung, Doo Hyun; Heo, Dae Seog; Bang, Yung-Jue
Issue Date
2006-11
Citation
Lung Cancer, Vol.54 No.2, pp.201-207
Keywords
non-small-cell lung cancergefitinibEGFR mutationpharmacogenomics
Abstract
Background: Clinical. predictors including Asian, female, adenocarcinoma and never-smoker and epidermal growth factor mutation are associated with gefitinib responsiveness in non-small-cell lung cancer. Direct comparison between clinical predictors and EGFR mutation for their predictive power has not been reported. Patients and methods: For 120 Korean NSCLC patients treated with gefitinib, we have analyzed EGFR mutational status in exons 18, 19 and 21. Patients were grouped according to the number of clinical predictors (female, adenocarcinoma and never-smoker). Response rate (RR), time-to-progression (TTP) and overall survival (OS) were analyzed. Multivariate analysis was performed to investigate which approach yielded better prediction. Results: RRs according to number of clinical predictors were 0: 3.4%, 1: 17.1%, 2: 29.4% and 3: 33.3% (p=0.002). Patients with gefitinib-sensitive EGFR mutation showed 61.9% RR compared with 12.1% in the remaining patients (p<0.001). RRs were higher in patients with the EGFR mutations regardless of the number of clinical predictors. In multivariate analysis, gefitinib-sensitive EGFR mutation showed higher odds ratio of response (9.6, 95% confidence interval, [CI] 3.2-28.7) compared with number of clinical predictors (1.7, 95% Cl 1.1-2.7). Hazard ratio (HR) of TTP was also better in gefitinib-sensitive EGFR mutation (0.24, 95% Cl 0.12-0.47) than number of clinical predictors (0.83, 95% Cl 0.69-0.99). Only gefitinib-sensitive EGFR mutation was associated with improved OS (HR 0.25, 95% Cl 0.12-0.52). Conclusion: EGFR mutation should be analyzed whenever possible for effective prediction of objective benefit from gefitinib in NSCLC patients with one or more clinical predictors. (C) 2006 Elsevier Ireland Ltd. All rights reserved.
ISSN
0169-5002
URI
http://hdl.handle.net/10371/165562
DOI
https://doi.org/10.1016/j.lungcan.2006.07.007
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College of Medicine/School of Medicine (의과대학/대학원)Cancer Research Institute (암연구소)Journal Papers (저널논문_암연구소)
College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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