Comparison of the effectiveness of erlotinib, gefitinib, and afatinib for treatment of non‑small cell lung cancer in patients with common and rare EGFR gene mutations

  • Authors:
    • Pawel Krawczyk
    • Dariusz M. Kowalski
    • Rodryg Ramlau
    • Ewa Kalinka‑Warzocha
    • Kinga Winiarczyk
    • Katarzyna Stencel
    • Tomasz Powrózek
    • Katarzyna Reszka
    • Kamila Wojas‑Krawczyk
    • Maciej Bryl
    • Magdalena Wójcik‑Superczyńska
    • Maciej Głogowski
    • Aleksander Barinow‑Wojewódzki
    • Janusz Milanowski
    • Maciej Krzakowski
  • View Affiliations

  • Published online on: April 3, 2017     https://doi.org/10.3892/ol.2017.5980
  • Pages: 4433-4444
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Abstract

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are routinely used to treat non-small cell lung cancer (NSCLC) in patients with common activating mutations of the EGFR gene. The aim of the study was to compare the efficacies of EGFR‑TKIs in patients with common (exon 19 deletions and exon 21 p.Leu858Arg) and rare EGFR mutations. A retrospective analysis of 180 NSCLC patients with common (n=167) and rare (n=13) EGFR mutations treated with erlotinib (n=98), gefitinib (n=66) and afatinib (n=16) was performed. EGFR mutations were determined using RT‑PCR and the EntroGen EGFR Mutations Analysis kit. Partial and complete response (PR and CR), progression‑free survival (PFS), and overall survival (OS) were analyzed. Demographic and clinical factors had no impact on PFS or OS in patients treated with EGFR-TKIs. Erlotinib, gefitinib, and afatinib showed similar efficacies based on treatment response, median PFS, and OS. The type of EGFR mutation had no impact on median OS; however, median PFS was significantly longer in patients with the exon 19 deletion compared to patients with the exon 21 p.Leu858Arg substitution and rare EGFR gene mutations (P=0.013). Patients with common EGFR mutations showed significantly longer median PFS than those with rare EGFR mutations (10 vs. 5 months; P=0.009). Erlotinib, gefitinib, and afatinib show similar efficacies in NSCLC patients with both common and rare EGFR mutations. When undergoing EGFR‑TKI treatment, patients with rare EGFR mutations showed similar OS but poorer PFS. Further investigation into the associations between particular rare EGFR mutations and EGFR-TKIs treatment outcomes is required.

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June 2017
Volume 13 Issue 6

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Copy and paste a formatted citation
APA
Krawczyk, P., Kowalski, D.M., Ramlau, R., Kalinka‑Warzocha, E., Winiarczyk, K., Stencel, K. ... Krzakowski, M. (2017). Comparison of the effectiveness of erlotinib, gefitinib, and afatinib for treatment of non‑small cell lung cancer in patients with common and rare EGFR gene mutations. Oncology Letters, 13, 4433-4444. https://doi.org/10.3892/ol.2017.5980
MLA
Krawczyk, P., Kowalski, D. M., Ramlau, R., Kalinka‑Warzocha, E., Winiarczyk, K., Stencel, K., Powrózek, T., Reszka, K., Wojas‑Krawczyk, K., Bryl, M., Wójcik‑Superczyńska, M., Głogowski, M., Barinow‑Wojewódzki, A., Milanowski, J., Krzakowski, M."Comparison of the effectiveness of erlotinib, gefitinib, and afatinib for treatment of non‑small cell lung cancer in patients with common and rare EGFR gene mutations". Oncology Letters 13.6 (2017): 4433-4444.
Chicago
Krawczyk, P., Kowalski, D. M., Ramlau, R., Kalinka‑Warzocha, E., Winiarczyk, K., Stencel, K., Powrózek, T., Reszka, K., Wojas‑Krawczyk, K., Bryl, M., Wójcik‑Superczyńska, M., Głogowski, M., Barinow‑Wojewódzki, A., Milanowski, J., Krzakowski, M."Comparison of the effectiveness of erlotinib, gefitinib, and afatinib for treatment of non‑small cell lung cancer in patients with common and rare EGFR gene mutations". Oncology Letters 13, no. 6 (2017): 4433-4444. https://doi.org/10.3892/ol.2017.5980