Characteristics and prognosis of EGFR mutations in small cell lung cancer patients in the NGS era

• Xiaohong Xie ^[1] ; Guihuan Qiu ^[1] ; Ziyao Chen ^[1] ; Ting Liu ^[1] ; Yilin Yang ^[1] ; Zhixuan You ^[1] ; Chen Zeng ^[1] ; Xinqing Lin ^[1] ; Zhanhong Xie ^[1] ; Yinyin Qin ^[1] ; Yansheng Wang ^[1] ; Xiaodong Ma ^[2] ; Chengzhi Zhou ^[1] ; Ming Liu ^[1]
  1. [1] The First Afliated Hospital of Guangzhou Medical University, National Center for Respiratory Medicine, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
  2. [2] Nanshan School, Guangzhou Medical University, Guangzhou, China
• Localización: Clinical & translational oncology, ISSN 1699-048X, Vol. 26, Nº. 2, 2024, págs. 434-445
• Idioma: inglés
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• Resumen

  • Purpose Targeted therapy has not been effective for small cell lung cancer (SCLC) patients. Although some studies have reported on EGFR mutations in SCLC, a systematic investigation into the clinical, immunohistochemical, and molecular characteristics and prognosis of EGFR-mutated SCLCs is lacking.

    Methods Fifty-seven SCLC patients underwent next-generation sequencing technology, with 11 in having EGFR mutations (group A) and 46 without (group B). Immunohistochemistry markers were assessed, and the clinical features and first-line treatment outcomes of both groups were analyzed.

    Results Group A consisted primarily of non-smokers (63.6%), females (54.5%), and peripheral-type tumors (54.5%), while group B mainly comprised heavy smokers (71.7%), males (84.8%), and central-type tumors (67.4%). Both groups showed similar immunohistochemistry results and had RB1 and TP53 mutations. When treated with tyrosine kinase inhibitors (TKIs) plus chemotherapy, group A had a higher treatment response rate with overall response and disease control rates of 80% and 100%, respectively, compared to 57.1% and 100% in group B. Group A also had a significantly longer median progression-free survival (8.20 months, 95% CI 6.91–9.49 months) than group B (2.97 months, 95% CI 2.79–3.15), with a significant difference (P = 0.043). Additionally, the median overall survival was significantly longer in group A (16.70 months, 95% CI 1.20–32.21) than in group B (7.37 months, 95% CI 3.85–10.89) (P = 0.016).

    Conclusion EGFR-mutated SCLCs occurred more frequently in non-smoking females and were linked to prolonged survival, implying a positive prognostic impact. These SCLCs shared immunohistochemical similarities with conventional SCLCs, and both types had prevalent RB1 and TP53 mutations.