title: Correlation between EGFR mutation status and response to first-line platinum-based chemotherapy in patients with advanced non-small cell lung cancer.
abstract: BACKGROUND
  The purpose of this research was to investigate the relationship between epidermal growth factor receptor (EGFR) mutations and the response to first-line chemotherapy in patients with advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  A total of 266 patients with stage IIIB or IV NSCLC who received platinum-based doublet therapies as first-line chemotherapy were investigated retrospectively, and their clinical data were assessed according to EGFR mutation.
  
  
  RESULTS
  EGFR mutations were identified in 45.5% of patients. There was no significant difference in response rate between EGFR mutation carriers and EGFR wild-type carriers (P=0.484). Among the patients with Kirsten rat sarcoma viral oncogene homolog (KRAS) wild-type, however, those with EGFR mutations responded better to treatment than EGFR wild-type patients (46.2% versus 20.8%, P=0.043). The disease control rate associated with pemetrexed-based treatments was higher than for vinorelbine-based therapies in EGFR mutation patients (P=0.001). EGFR mutation was found in patients with longer progression-free survival and median survival time, and improved 1-year and 2-year overall survival when compared with EGFR wild-type patients (6.1 versus 5.0 months, P=0.004; 18.9 versus 13.8 months, P=0.001; 81.0% versus 63.4%, P=0.002; and 33.9% versus 22.8% P=0.044, respectively). Patients with the EGFR exon 19 mutation had longer progression-free survival than those with EGFR exon 21 mutation (P=0.007). Multivariate analysis showed that the response to first-line chemotherapy and the presence of EGFR mutations were independent prognostic factors in patients with advanced NSCLC.
  
  
  CONCLUSIONS
  Our data showed that the presence of EGFR mutations meant longer survival times for patients with advanced NSCLC who received platinum-based doublet first-line chemotherapy, especially in those with the exon 19 deletion mutation. Among KRAS wild-type patients, those with EGFR mutation responded better to first-line chemotherapy than EGFR wild-type patients.
authors: School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, People's Republic of China.
authors: Shu
authors: S
authors: Fang
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Zhehai
authors: Z
authors: Wang
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Jun
authors: J
authors: Guo
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Jie
authors: J
authors: Liu
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Changzheng
authors: C
authors: Li
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Lin
authors: L
authors: Liu
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Huan
authors: H
authors: Shi
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Liyan
authors: L
authors: Liu
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Huihui
authors: H
authors: Li
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Chao
authors: C
authors: Xie
authors: Department of Oncology, Shandong Cancer Hospital, Jinan, Shandong Province, People's Republic of China.
authors: Xia
authors: X
authors: Zhang
authors: School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, People's Republic of China.
authors: Wenwen
authors: W
authors: Sun
authors: School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Jinan, Shandong Province, People's Republic of China.
authors: Minmin
authors: M
authors: Li
keywords: chemotherapeutic agents; epidermal growth factor receptor mutation; non-small cell lung cancer; prognosis; targeted therapy