Thoracic Oncology Service, Division of Solid Tumor Oncology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, 300 East 66 Street, New York, NY 10065, USA.
Mol Cancer Ther. 2012 Nov;11(11):2535-40. doi: 10.1158/1535-7163.MCT-12-0163. Epub 2012 Aug 14.
We previously reported that although EGFR mutations are not a feature of pure squamous cell carcinomas (SCC) of the lung, these mutations do occur in adenosquamous carcinomas (AD-SCC) and in rare solid adenocarcinomas, both of which can mimic SCC in small samples. Here we present an expanded series of these cases with a focus on sensitivity to erlotinib. The study included 13 patients with EGFR mutant lung carcinomas, which after detailed pathologic review were classified as AD-SCC (n = 11) or solid adenocarcinoma (n = 2). The majority received a diagnosis of SCC in at least 1 sample. All patients were treated with erlotinib. Eight of 11 patients with AD-SCC were evaluable for response. Their overall response rate was 88% (7/8; 95% CI, 47% to 99%). One of 2 solid adenocarcinoma patients responded to erlotinib. As a group, median progression-free survival was 12 months (95% CI, 8 to not reached); median overall survival was 29 months (95% CI, 27 to not reached). In conclusion, EGFR mutant AD-SCC and solid adenocarcinoma show a response to erlotinib that is comparable to that seen in patients with conventional adenocarcinoma. These tumors can mimic SCC in small samples. We propose an approach to increase the capture of these rare histology patients for EGFR mutation testing.
我们之前曾报道过,尽管 EGFR 突变不是纯肺鳞癌(SCC)的特征,但这些突变确实存在于腺鳞癌(AD-SCC)和罕见的实性腺癌中,这两种肿瘤在小样本中均可模拟 SCC。在此,我们呈现了一系列扩展病例,重点关注厄洛替尼的敏感性。该研究纳入了 13 例 EGFR 突变型肺癌患者,经过详细的病理复习,这些患者被分类为 AD-SCC(n=11)或实性腺癌(n=2)。大多数患者在至少 1 个样本中被诊断为 SCC。所有患者均接受厄洛替尼治疗。11 例 AD-SCC 患者中有 8 例可评估疗效。其总体缓解率为 88%(7/8;95%CI,47%至 99%)。2 例实性腺癌患者中有 1 例对厄洛替尼有反应。总体而言,中位无进展生存期为 12 个月(95%CI,8 至未达到);中位总生存期为 29 个月(95%CI,27 至未达到)。总之,EGFR 突变型 AD-SCC 和实性腺癌对厄洛替尼的反应与传统腺癌患者相似。这些肿瘤在小样本中可模拟 SCC。我们提出了一种方法,以增加对这些罕见组织学患者进行 EGFR 突变检测的机会。