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Gün E, Ebru Çakır İ, Ersöz H, Oflazoğlu U, Sertoğullarından B. The Epidermal Growth Factor, Anaplastic Lymphoma Kinase, and ROS Proto-oncogene 1 Mutation Profile of Non-Small Cell Lung Carcinomas in the Turkish Population: A Single-Center Analysis. THORACIC RESEARCH AND PRACTICE 2024; 25:102-109. [PMID: 39162236 PMCID: PMC11181205 DOI: 10.5152/thoracrespract.2024.23067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 01/31/2024] [Indexed: 08/21/2024]
Abstract
The management of non-small cell lung carcinomas (NSCLC) has changed with the identification of molecular pathways. We aimed to reveal the 3-year epidermal growth factor (EGFR), anaplastic lymphoma kinase (ALK), and ROS proto-oncogene 1 (ROS1) mutation profile in the Turkish population. The histopathological and molecular data of all NSCLC cases from our department between May 2019 and April 2022 were evaluated. Molecular testing was performed in 197 NSCLC cases, and results were obtained in 182 (92.4%) (M/F: 144/38, aged 39-86). Of these, 121 were diagnosed with adenocarcinoma, 36 with squamous cell carcinoma, and 25 with NSCLC-not otherwise specified. The EGFR mutation was seen in 21 (11.5%) cases (6 exon 19 deletions, 3 exon 18 [all codon 719], 2 exon 20, 8 exon 21 point mutations, 1 concurrent exon 19 deletion and exon 20 codon 790 M point mutation, and 1 concurrent exon 19 deletion and exon 21 point mutation). The double mutation rate of EGFR was 1.1%. The mean age of these patients was 63.4 (40-79), with 24% of all females (n = 9) and 8.3% of all males (n = 12). The ALK mutation was detected in 6 (3.3%) patients (M/F: 4/2, aged 45-82), whereas the ROS1 mutation was detected in 3 (1.7%) (M/F: 2/1, aged 40-64). It is well established in the literature that EGFR-activating mutation rates vary depending on regions and ethnic groups. We concluded that the EGFR-activating mutation rates of the Turkish population are similar to the European molecular data instead of the Asian. The ALK and ROS1 mutation rates also seem concordant with the literature.
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Affiliation(s)
- Eylül Gün
- Department of Cellular Pathology, Basildon & Thurrock University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, Essex, United Kingdom
| | - İzzetiye Ebru Çakır
- Department of Pathology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Hasan Ersöz
- Department of Thoracic Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Utku Oflazoğlu
- Department of Medical Oncology, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye
| | - Bünyamin Sertoğullarından
- Department of Thoracic Diseases, İzmir Katip Çelebi University Atatürk Training and Research Hospital, İzmir, Türkiye
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Dalurzo ML, Avilés-Salas A, Soares FA, Hou Y, Li Y, Stroganova A, Öz B, Abdillah A, Wan H, Choi YL. Testing for EGFR Mutations and ALK Rearrangements in Advanced Non-Small-Cell Lung Cancer: Considerations for Countries in Emerging Markets. Onco Targets Ther 2021; 14:4671-4692. [PMID: 34511936 PMCID: PMC8420791 DOI: 10.2147/ott.s313669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/08/2021] [Indexed: 12/24/2022] Open
Abstract
The treatment of patients with advanced non-small-cell lung cancer (NSCLC) in recent years has been increasingly guided by biomarker testing. Testing has centered on driver genetic alterations involving the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) rearrangements. The presence of these mutations is predictive of response to targeted therapies such as EGFR tyrosine kinase inhibitors (TKIs) and ALK TKIs. However, there are substantial challenges for the implementation of biomarker testing, particularly in emerging countries. Understanding the barriers to testing in NSCLC will be key to improving molecular testing rates worldwide and patient outcomes as a result. In this article, we review EGFR mutations and ALK rearrangements as predictive biomarkers for NSCLC, discuss a selection of appropriate tests and review the literature with respect to the global uptake of EGFR and ALK testing. To help improve testing rates and unify procedures, we review our experiences with biomarker testing in China, South Korea, Russia, Turkey, Brazil, Argentina and Mexico, and propose a set of recommendations that pathologists from emerging countries can apply to assist with the diagnosis of NSCLC.
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Affiliation(s)
- Mercedes L Dalurzo
- Department of Pathology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | | | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yuan Li
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
| | - Anna Stroganova
- N.N. Blokhin National Medical Research Centre of Oncology, Russian Academy of Medical Sciences, Moscow, Russia
| | - Büge Öz
- Cerrahpaşa School of Medicine, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Arif Abdillah
- Takeda Pharmaceuticals International AG – Singapore Branch, Singapore, Singapore
| | - Hui Wan
- Takeda Pharmaceuticals International AG – Singapore Branch, Singapore, Singapore
| | - Yoon-La Choi
- Department of Pathology and Translational Genomics, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Lahmadi M, Beddar L, Rouibah AL, Boumegoura A, Boufendi H, Temim A, Nini A, Sellam F, Satta D. Analysis of EGFR Mutation Status in Algerian Patients with Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev 2021; 22:1063-1068. [PMID: 33906297 PMCID: PMC8325123 DOI: 10.31557/apjcp.2021.22.4.1063] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Indexed: 12/24/2022] Open
Abstract
Background and objective: Epidermal growth factor receptor (EGFR) mutation status is used as a predictive biomarker for the tyrosine kinase inhibitors therapy in non-small cell lung cancer (NSCLC). The incidence of EGFR mutations appears to vary according to ethnic and geographical backgrounds. This retrospective study aimed to investigate the EGFR mutation status in Algerian NSCLC patients and its association with clinicopathological features. Methods: We examined the presence of EGFR mutations (Exons 19-21) in 58 unselected NSCLC samples using PCR followed by direct sequencing. Results: The present study included 53 (91.4%) men and 5 (8.6%) women, with a median age of 59 (ranging from 44 to 94 years old). EGFR mutations were detected in 23 patients, with an overall rate of 39.6%. There were 21 (91.3%) cases with the exon-21 L585R single mutation and two (8.7%) with dual mutations of exon-19 deletions and L585R. EGFR mutations were more frequently found in patients with confirmed adenocarcinoma (14/27, 51.8%) than in non-adenomatous NCSCL subtypes (3/14, 21.4%; p=0.03). Furthermore, early stages of the disease were significantly associated with a higher rate of EGFR mutations (14/27, 51.8%) compared with those at advanced stage (5/21, 23.8%; p=0.02). There were no significant differences in EGFR mutation frequency by age, gender, or smoking status. Conclusion: We found that Algerian NSCLC patients exhibited a high rate of EGFR mutations, which was quite similar to that in Asians population rather than Caucasian patients. Thus, TKI-based treatments may be more beneficial for Algerian patients with NSCLC. Further studies using a large number of patients are required to confirm our preliminary findings.
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Affiliation(s)
- Mohamed Lahmadi
- Department of Animal Biology, University of Mentouri Brothers Constantine 1, Constantine, Algeria.,Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Leila Beddar
- Department of Anatomical Pathology, Ben-Badis Hospital, Faculty of Medicine University of Constantine 3, Constantine, Algeria
| | | | - Ali Boumegoura
- Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Houda Boufendi
- Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Asma Temim
- Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Anissa Nini
- Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Feriel Sellam
- Biotechnology Research Center (CRBt), Constantine, Algeria
| | - Dalila Satta
- Department of Animal Biology, University of Mentouri Brothers Constantine 1, Constantine, Algeria
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Evaluation of epidermal growth factor receptor mutations and thyroid transcription factor-1 status in Turkish non-small cell lung carcinoma patients: A study of 600 cases from a single center. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2020; 28:143-150. [PMID: 32175155 DOI: 10.5606/tgkdc.dergisi.2020.18196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 09/17/2019] [Indexed: 12/13/2022]
Abstract
Background This study aims to investigate the frequency, distribution, and morphological/immunohistochemical features of epidermal growth factor receptor mutations and to examine the possible relationship between the material type and technical success of mutation analysis in Turkish population with non-small cell lung cancer. Methods Between September 2012 and December 2015, a total of 499 consecutive, treatment-naïve patients (437 males, 163 females; mean age 61 years; range, 30 to 84 years) with primary or metastatic non-small cell lung cancer who underwent epidermal growth factor receptor mutation testing using Sanger sequencing method were retrospectively analyzed. Archival records and hematoxylin-eosine and immunohistochemically stained sections were re-examined. The thyroid transcription factor-1 and napsin A immunohistochemical stains were performed on tissue array blocks. Results Seventy-five mutations were detected in 70 patients (14%). The success rate of testing and intact deoxyribonucleic acid fragment length were significantly higher in the cytological material, compared to tissue specimens (p<0.001). The mutation rate in adenocarcinomas was 33.9% for women and 9.4% for men. The most common mutation was L746-E750del in exon 19 (29.3%), followed by the L858R mutation in exon 21 (28%). The mutation rate was the highest in micropapillary (40%) and lowest in solid (5.4%) adenocarcinomas. All epidermal growth factor receptor mutations, except for one, were positive for the thyroid transcription factor-1. The single nucleotide polymorphism Q787Q in exon 20 was observed in 79.6% of patients. Conclusion The frequency and distribution of epidermal growth factor receptor mutations in the Turkish patients with non-small cell lung cancer are similar to the European populations. These results also demonstrate that cytological materials are highly reliable for epidermal growth factor receptor mutation testing, and the probability of detection of wild-type epidermal growth factor receptor is low in cases of thyroid transcription factor-1 negativity.
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Falla-Martinez JC, Espinosa D, Baena JC, Rodriguez LX, Sua LF, Zambrano AR. An endothelial growth factor receptor compound mutation of T790M substitution with exon 19 deletion in a previously untreated patient: a case report. J Med Case Rep 2019; 13:144. [PMID: 31088573 PMCID: PMC6518648 DOI: 10.1186/s13256-019-2075-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 04/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endothelial growth factor receptor (EGFR) mutations are an essential driver of personalized therapy for patients with lung cancer and are detected in approximately 15% of Caucasian and 50% of Asian patients. EGFR tyrosine kinase inhibitors have been developed and used for this set of patients. T790M mutation in exon 20 is usually associated with secondary resistance to EGFR tyrosine kinase inhibitors therapy but is also present in treatment-naïve patients. The frequency for baseline T790M mutation varies from 4 to 35% according to the detection method used. Newer techniques have yielded higher rates, but concerns about false-positive results have been raised. Compound mutations account for 4-14% of all EGFR-mutated tumors, with no studies yet to provide a frequency rate for T790M + 19 deletion association due to the small number of cases. However, there are reports that pretreatment T790M + L858R association is significantly more frequent compared to T790M + exon 19 deletion mutations. Diagnostic challenges, current knowledge on the subject, and therapeutic decisions are discussed. CASE PRESENTATION We present the case of a 43-year-old Hispanic woman, a treatment-naïve patient, with metastasized lung cancer adenocarcinoma harboring a T790M deletion along with the classic 19 mutation. The initial symptoms were monoparesis of her left leg, associated with hyperreflexia, and hypoesthesia. In the absence of third-generation tyrosine kinase inhibitors, a platinum-based therapy was initiated with no response and she died 4 months after diagnosis. CONCLUSIONS Osimertinib seems to be a suitable therapy for treatment-naïve patients with sensitizing and resistant compound EGFR mutations. More studies regarding the clinical characteristics of these patients and the appropriate management of this condition are needed to provide the highest standard of care.
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Affiliation(s)
- Juan C Falla-Martinez
- Hematology-Oncology department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Fundacion Valle del Lili, Cali, Colombia
| | - Daniela Espinosa
- Internal Medicine department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia
| | - Juan C Baena
- Hematology-Oncology department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Fundacion Valle del Lili, Cali, Colombia
| | - Lisa X Rodriguez
- Human Genetics department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia
| | - Luz F Sua
- Pathology department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Cali, Colombia
| | - Angela R Zambrano
- Hematology-Oncology department, Fundacion Valle del Lili, Carrera 98 No. 18-49, Fundacion Valle del Lili, Cali, Colombia.
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