Mutations of the EGFR and K-ras genes in resected stage I lung adenocarcinoma and their clinical significance.

Abstract

PURPOSE:

This study retrospectively assessed the mutations of the epidermal growth factor receptor (EGFR) and K-ras genes and their clinical significance in patients with resected stage I adenocarcinomas.

METHODS:

A total of 354 patients with resected lung adenocarcinomas were included, and 256 patients with stage I disease were analyzed for the prognostic and predictive value of these mutations.

RESULTS:

Mutations of EGFR and K-ras genes were detected in 149 (41.1 %) and 23 (6.4 %) of all tumors, and in 122 (47.6 %) and 14 (5.5 %) of stage I tumors, respectively. There were no significant differences in the disease-free survival (DFS) and overall survival (OS) between the EGFR-mutant and wild-type groups. However, the DFS and OS were significantly shorter in patients with K-ras mutations than in those without (5-year DFS: 50.8 vs. 76.9 %, 5-year OS: 70.0 vs. 86.6 %, p < 0.01). A multivariate analysis showed that K-ras mutations were an independent poor prognostic factor. Twenty-four of the 41 patients with recurrent disease after surgery were treated with an EGFR-TKI. Fifteen EGFR-mutant patients treated with an EGFR-TKI had a better prognosis than did the nine EGFR-wild-type patients.

CONCLUSION:

The presence of an EGFR gene mutation was a predictive factor for the response to EGFR-TKI treatment in patients with resected stage I adenocarcinoma, but was not a prognostic factor. The presence of a K-ras gene mutation was a poor prognostic factor.

• Authors: Taro Ohba, Gouji Toyokawa, Takuro Kometani, Kaname Nosaki, Fumihiko Hirai, Masafumi Yamaguchi, Motoharu Hamatake, Takashi Seto, Yukito Ichinose, Kenji Sugio
• Journal: Surgery today (Surg Today) Vol. 44 Issue 3 Pg. 478-86 (Mar 2014) ISSN: 1436-2813 [Electronic] Japan
• PMID: 23609009 (Publication Type: Journal Article)

Chemical References

• Protein Kinase Inhibitors
• EGFR protein, human
• ErbB Receptors
• Protein-Tyrosine Kinases

Topics

• Adenocarcinoma (genetics, mortality, pathology, therapy)
• Adult
• Aged
• Aged, 80 and over
• Disease-Free Survival
• ErbB Receptors (genetics)
• Female
• Genes, ras (genetics)
• Humans
• Lung Neoplasms (genetics, mortality, pathology, therapy)
• Male
• Middle Aged
• Multivariate Analysis
• Mutation
• Neoplasm Staging
• Predictive Value of Tests
• Prognosis
• Protein Kinase Inhibitors (therapeutic use)
• Protein-Tyrosine Kinases (antagonists & inhibitors)
• Retrospective Studies
• Survival Rate