title: Non-small Cell Lung Cancer in South Wales: Are Exon 19 Deletions and L858R Different?
abstract: OBJECTIVE
  In advanced non-small cell lung cancer (NSCLC), the epidermal growth factor receptor (EGFR) mutations L858R and exon 19 deletion (del19) predict response to EGFR tyrosine kinase inhibitors (TKIs). Trials have suggested a differential response to the second-generation EGFR TKI afatinib in favour of del19. We investigated whether this differential response is observed in clinical practice.
  
  
  METHODS
  Retrospective demographic, treatment and outcome data were collected on patients with: stage III/IV NSCLC and either del19 or L858R, receiving an EGFR TKI as first-line treatment.
  
  
  RESULTS
  There was no significant difference in overall survival (OS) between del19 (648 days, 95% confidence interval (CI)=461-835) and L858R (813 days, 95%CI=387-1,238), (p=0.616), or in duration of therapy between del19 (365 days, 95% CI=192-538) and L858 (428 days, 95% CI=263-593), (p=0.928).
  
  
  CONCLUSIONS
  Patients with exon del19 did not have a significantly longer OS with first-generation TKIs.
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K. rhian.s.davies@wales.nhs.uk.
authors.forename: Rhian Siân
authors.initials: RS
authors.lastname: Davies
authors.affiliation: Institute of Cancer Genetics, Cardiff University, Cardiff, Wales, U.K.
authors.forename: Daniel John
authors.initials: DJ
authors.lastname: Nelmes
authors.affiliation: Institute of Cancer Genetics, Cardiff University, Cardiff, Wales, U.K.
authors.forename: Rachel
authors.initials: R
authors.lastname: Butler
authors.affiliation: Velindre Cancer Centre, Cardiff, Wales, U.K.
authors.forename: Jason Francis
authors.initials: JF
authors.lastname: Lester
mesh_terms: D000328:Adult; D000077716:Afatinib; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics*; D005091:Exons / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use; D012189:Retrospective Studies; D017384:Sequence Deletion / Q000235:genetics; D014852:Wales / Q000453:epidemiology
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000077716:Afatinib; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: EGFR mutation; L858R; NSCLC; advanced non-small cell lung cancer; exon 19 deletion