1. Discordance of epidermal growth factor receptor mutation between primary lung tumor and paired distant metastases in non-small cell lung cancer: A systematic review and meta-analysis
- Author
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Chia Ching Lee, Wee Yao Koh, Jeremy Tey, Char Loo Tan, Yu Yang Soon, Cheng Nang Leong, and Ivan Weng Keong Tham
- Subjects
0301 basic medicine ,Oncology ,Physiology ,Lung and Intrathoracic Tumors ,Metastasis ,Central Nervous System Neoplasms ,0302 clinical medicine ,Endocrinology ,Mathematical and Statistical Techniques ,Epidermal growth factor ,Carcinoma, Non-Small-Cell Lung ,Basic Cancer Research ,Medicine and Health Sciences ,Epidermal growth factor receptor ,Neoplasm Metastasis ,Multidisciplinary ,biology ,Statistics ,Metaanalysis ,Primary tumor ,ErbB Receptors ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Meta-analysis ,Mutation (genetic algorithm) ,Physical Sciences ,Medicine ,Research Article ,medicine.medical_specialty ,Science ,Bone Neoplasms ,Research and Analysis Methods ,03 medical and health sciences ,Internal medicine ,Growth Factors ,medicine ,Genetics ,Humans ,Statistical Methods ,Lung cancer ,Lung ,Endocrine Physiology ,Epidermal Growth Factor ,business.industry ,Cancers and Neoplasms ,Biology and Life Sciences ,medicine.disease ,Non-Small Cell Lung Cancer ,030104 developmental biology ,Metastatic Tumors ,Mutation ,biology.protein ,Secondary Lung Tumors ,business ,Mathematics - Abstract
PurposeTo evaluate the rate of discordance of epidermal growth factor receptor (EGFR) mutation between primary lung tumor and paired distant metastases in non-small-cell lung cancer (NSCLC).MethodsWe performed a meta-analysis of 17 studies (518 cases) assessing discordance rates of EGFR mutation in primary tumors and paired distant metastases. We performed subgroup analyses based on EGFR mutation status in primary tumor (mutant or wildtype), site of distant metastasis (bone, central nervous system (CNS) or lung/ pleural), methods of testing (direct sequencing or allele-specific testing) and timing of metastasis (synchronous or metachronous).ResultsThe overall discordance rate in EGFR mutation was low at 10.36% (95% CI = 4.23% to 18.79%) and varied widely between studies (I2 = 83.18%). The EGFR discordance rate was statistically significantly higher in bone metastases (45.49%, 95% CI = 14.13 to 79.02) than CNS (17.26%, 95% CI = 7.64 to 29.74; P = 0.002) and lung/ pleural metastases (8.17%, 95% CI = 3.35 to 14.85; P < 0.001). Subgroup analyses did not demonstrate any significant effect modification on the discordance rates by the EGFR mutation status in primary lung tumor, methods of testing and timing of metastasis.ConclusionThe overall discordance rate in EGFR mutation between primary lung tumor and paired distant metastases in NSCLC is low, although higher discordance rates were observed in bone metastases compared with CNS and lung/pleural metastases. Future studies assessing the impact of EGFR mutation discordance on treatment outcomes are required.
- Published
- 2019