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EGFR mutations detected on cytology samples by a centralized laboratory reliably predict response to gefitinib in non-small cell lung carcinoma patients

EGFR mutations detected on cytology samples by a centralized laboratory reliably predict response to gefitinib in non-small cell lung carcinoma patients

Authors :
MALAPELLE, UMBERTO
Salatiello M
Rocco D
de Rosa N
Vitiello F
Russo S
Pepe F
Iaccarino A
Micheli P
Illiano A
Piantedosi FV
BELLEVICINE, CLAUDIO
DE LUCA, CATERINA
DE STEFANO, ALFONSO
CARLOMAGNO, Chiara
TRONCONE, GIANCARLO
Malapelle, Umberto
Bellevicine, Claudio
DE LUCA, Caterina
Salatiello, M
DE STEFANO, Alfonso
Rocco, D
de Rosa, N
Vitiello, F
Russo, S
Pepe, F
Iaccarino, A
Micheli, P
Illiano, A
Carlomagno, Chiara
Piantedosi, Fv
Troncone, Giancarlo
Publication Year :
2013

Abstract

BACKGROUND: Epidermal growth factor receptor (EGFR) mutations are reliably detected by referral laboratories, even if most lung cancer cytology specimens sent to such laboratories contain very few cells. However, EGFR mutations may be distributed heterogeneously within tumors, thereby raising concerns that mutations detected on cytology are not representative of the entire tumor and, thus, are less reliable in predicting response to tyrosine kinase inhibitor (TKI) treatment than mutations detected on histology. To address this issue, the authors reviewed their clinical practice archives and compared the outcome of TKI treatment among patients who were selected by cytology versus patients who were selected by histology. METHODS: From July 2010 to July 2012, 364 cytology samples and 318 histology samples were received. Exon 19 deletions and the L858R point mutation in exon 21, detected by fragment assay and TaqMan assay, respectively, were confirmed by direct sequencing; discrepancies were resolved by cloning polymerase chain reaction products. The response rate (RR) and progression-free survival (PFS) at 12 months (range, 3-34 months) were evaluable in 13 EGFRmutated patients who were selected for treatment by cytology and 13 patients who were selected by histology. RESULTS: The mutation rate was similar in histology samples (8.5%) and cytology samples (8.8%). The RR (54%) and PFS (9.2 months) were similar in histologically selected patients and cytologically selected patients (RR, 62%; PFS, 8.6 months; P5.88). The disease control rate (responsive plus stable disease) was 92% in histologically selected patients and 100% in cytologically selected patients. CONCLUSIONS: EGFR mutations detected on cytology specimens by a centralized laboratory can predict TKI treatment response equally well as mutations identified on histology samples.

Details

Language :
English
Database :
OpenAIRE
Accession number :
edsair.od......3730..c0cebb16155a6781f6bf1fc993712123