title: Molecular Epidemiology of EGFR Mutations in Asian Patients with Advanced Non-Small-Cell Lung Cancer of Adenocarcinoma Histology - Mainland China Subset Analysis of the PIONEER study.
abstract: Epidermal growth factor receptor (EGFR) mutations are the strongest response predictors to EGFR tyrosine kinase inhibitors (TKI) therapy, but knowledge of the EGFR mutation frequency on lung adenocarcinoma is still limited to retrospective studies. The PIONEER study (NCT01185314) is a prospective molecular epidemiology study in Asian patients with newly diagnosed advanced lung adenocarcinoma, aiming to prospectively analyze EGFR mutation status in IIIB/IV treatment-naïve lung adenocarcinomas in Asia. We report the mainland China subset results. Eligible patients (≥20 yrs old, IIIB/IV adenocarcinoma and treatment-naïve) were registered in 17 hospitals in mainland China. EGFR was tested for mutations by amplification refractory mutation system using biopsy samples. Demographic and clinical characteristics were collected for subgroup analyses. A total of 747 patients were registered. Successful EGFR mutation analysis was performed in 741, with an overall mutation rate of 50.2%. The EGFR active mutation rate is 48.0% (with 1.3% of combined active and resistance mutations). Tobacco use (>30 pack-year vs. 0-10 pack-year, OR 0.27, 95%CI: 0.17-0.42) and regional lymph nodes involvement (N3 vs. N0, OR 0.47, 95%CI: 0.29-0.76) were independent predictors of EGFR mutation in multivariate analysis. However, even in regular smokers, the EGFR mutation frequency was 35.3%. The EGFR mutation frequency was similar between diverse biopsy sites and techniques. The overall EGFR mutation frequency of the mainland China subset was 50.2%, independently associated with the intensity of tobacco use and regional lymph nodes involvement. The relatively high frequency of EGFR mutations in the mainland China subset suggest that any effort to obtain tissue sample for EGFR mutation testing should be encouraged.
authors.affiliation: Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No.17 Panjiayuan Nanli, Chaoyang District, Beijing (100021), China.
authors.forename: Yuankai
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No.17 Panjiayuan Nanli, Chaoyang District, Beijing (100021), China.
authors.forename: Junling
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Beijing Chest Hospital, Capital Medical University, Beijing (1011429), China.
authors.forename: Shucai
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Respiration Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing (100005), China.
authors.forename: Mengzhao
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, Henan Cancer Hospital, Zhengzhou (450008), Henan Province, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Medical Oncology, Guangzhou Chest Hospital, Guangzhou (510095), Guangdong Province, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Li
authors.affiliation: Cancer Center, Union Hospital, Tongji Medical College HuaZhong University of Science and Technology, Wuhan (430030), Hubei Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Medical Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang (050035), Hebei Province, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, The 309th Hospital of Chinese People's Liberation Army, Beijing (100091), China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Liao
authors.affiliation: Department of Medical Oncology, Nanfang Hospital, Southern Medical University, Guangzhou (510515), Guangdong Province, China.
authors.forename: Kaican
authors.initials: K
authors.lastname: Cai
authors.affiliation: Department of Respiration Medicine, Chinese People's Liberation Army General Hospital, Beijing (100853), China.
authors.forename: Liang'an
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Liaoning Cancer Hospital, Shenyang (110042), Liaoning Province, China.
authors.forename: Meizhen
authors.initials: M
authors.lastname: Zheng
authors.affiliation: Department of Medical Oncology, Sichuan Cancer Hospital, Chengdu (610041), Sichuan Province, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Yu
authors.affiliation: Department of Medical Oncology, Qilu Hospital, Shandong University, Jinan (250012), Shandong Province, China.
authors.forename: Xiuwen
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology, The First Hospital of China Medical University, Shenyang (110001), Liaoning Province, China.
authors.forename: Yunpeng
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Shandong Cancer Hospital, Jinan (250117), Shandong Province, China.
authors.forename: Qisen
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Respiration Medicine, Peking University First Hospital, Beijing (100034), China.
authors.forename: Ligong
authors.initials: L
authors.lastname: Nie
authors.affiliation: Department of Medical Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian (116011), Liaoning Province, China.
authors.forename: Jiwei
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs, No.17 Panjiayuan Nanli, Chaoyang District, Beijing (100021), China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics*; D002681:China; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology / Q000379:methods*; D009154:Mutation; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors