Epidermal growth factor receptor mutations in cells from non-small cell lung cancer malignant pleural effusions.
BACKGROUND
The prevalence of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) patients is about 40-50% in Taiwan, and there are significant correlations between EGFR mutations and clinical responses after gefitinib treatment. For most patients with advanced disease, surgical intervention for tissue sampling is not feasible. We therefore conducted this study to survey EGFR mutations in cells from NSCLC malignant pleural effusions and to evaluate the clinical significance.


METHODS
In the present study, malignant pleural effusion cells from 29 NSCLC patients were studied for EGFR mutations. Exons 18, 19, 20, 21 of the EGFR gene were analyzed by polymerase chain reaction (PCR) and automated sequencing. For 11 patients who had received gefitinib therapy, correlations between gefitinib effect and EGFR mutations were also evaluated.


RESULTS
EGFR mutations were detected in 12 of 29 specimens (41%). In-frame deletion mutations in exon 19 (8 of 12 specimens, 67%) and missense mutations in exon 21 (3 of 12 specimens, 25%) were the most frequent mutations detected. The frequency of EGFR mutations was significantly higher in gefitinib responders (4/4) than non-responders (1/7) (p = 0.015).


CONCLUSIONS
Our results suggest that detecting EGFR mutations in cells from malignant pleural effusions is a feasible adjunct method to finding the subgroup with favorable response to gefitinib therapy among patients with advanced NSCLC.
Hung
Ming-Szu
MS
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, 6 West Chiapu Road, Putzu City, Chiayi, Taiwan 613, ROC.
Lin
Chin-Kuo
CK
Leu
Shaw-Wei
SW
Wu
Mei-Yi
MY
Tsai
Ying-Huang
YH
Yang
Cheng-Ta
CT
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D016066:Pleural Effusion, Malignant / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D011799:Quinazolines / Q000627:therapeutic use
D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib