拉丁美洲非小细胞肺癌中 EGFR 和 KRAS 基因突变的更新频率：拉丁美洲肺癌研究联合会（CLICaP）。

Updated Frequency of EGFR and KRAS Mutations in NonSmall-Cell Lung Cancer in Latin America: The Latin-American Consortium for the Investigation of Lung Cancer (CLICaP).

机构信息

Thoracic Oncology Clinic and Experimental Oncology Laboratory, Instituto Nacional de Cancerologia de México, México D.F., México.

Clinical and Translational Oncology Group, Fundación Santa Fe de Bogotá, Bogotá, Colombia.

出版信息

J Thorac Oncol. 2015 May;10(5):838-843. doi: 10.1097/JTO.0000000000000481.

DOI:10.1097/JTO.0000000000000481

PMID:25634006

Abstract

INTRODUCTION

Previously, we reported the frequency of epidermal growth factor receptor (EGFR) and KRAS mutations in nonsmall-cell lung cancer (NSCLC) patients in Latin America. The EGFR mutation frequency was found between Asian (40%) and Caucasian (15%) populations. Here, we report the updated distribution of NSCLC mutations.

METHODS

A total of 5738 samples from NSCLC patients from Argentina (1713), Mexico (1417), Colombia (1939), Peru (393), Panama (174), and Costa Rica (102) were genotyped for EGFR and KRAS.

RESULTS

The median patient age was 62.2 ± 12.3 years; 53.5% were women, 46.7% had a history of smoking, and 95.2% had adenocarcinoma histology. The frequency of EGFR mutations was 26.0% (95% confidence interval [CI], 24.9-27.1; Argentina, 14.4% [12.8-15.6]; México, 34.3% [31.9-36.7]; Colombia, 24.7% [22.8-26.6]; Peru, 51.1% [46.2-55.9]; Panamá, 27.3 [20.7-33.9]; and Costa Rica, 31.4% [22.4-40.4]). The frequency of KRAS mutations was 14.0% (9.1-18.9). In patients with adenocarcinoma, EGFR mutations were independently associated with gender (30.7% females vs. 18.4% males; p < 0.001), nonsmoker status (27.4% vs. 17.1%, p < 0.001), ethnicity (mestizo/indigenous, 35.3% vs. Caucasian, 13.7%, p < 0.001), and the absence of KRAS mutation (38.1% vs. 4.7%; p < 0.001). The overall response rate to EGFR tyrosine kinase inhibitors was 60.6% (95% CI, 52-69), with a median progression-free survival and overall survival of 15.9 (95% CI, 12.420.6) and 32 months (95% CI, 26.5-37.6), respectively.

CONCLUSION

Our findings support the genetic heterogeneity of NSCLC in Latin America, confirming that the frequency of EGFR mutations is intermediate between that observed in the Asian and Caucasian populations.

摘要

介绍

此前，我们报道了拉丁美洲非小细胞肺癌（NSCLC）患者表皮生长因子受体（EGFR）和 KRAS 突变的频率。EGFR 突变频率在亚洲（40%）和高加索人（15%）之间。在此，我们报告 NSCLC 突变的最新分布情况。

方法

对来自阿根廷（1713 例）、墨西哥（1417 例）、哥伦比亚（1939 例）、秘鲁（393 例）、巴拿马（174 例）和哥斯达黎加（102 例）的 5738 例 NSCLC 患者的样本进行 EGFR 和 KRAS 基因分型。

结果

中位患者年龄为 62.2±12.3 岁；53.5%为女性，46.7%有吸烟史，95.2%为腺癌组织学类型。EGFR 突变频率为 26.0%（95%置信区间[CI]，24.9-27.1；阿根廷，14.4%[12.8-15.6]；墨西哥，34.3%[31.9-36.7]；哥伦比亚，24.7%[22.8-26.6]；秘鲁，51.1%[46.2-55.9]；巴拿马，27.3%[20.7-33.9]；哥斯达黎加，31.4%[22.4-40.4]）。KRAS 突变频率为 14.0%（9.1-18.9）。在腺癌患者中，EGFR 突变与性别（女性 30.7% vs. 男性 18.4%；p<0.001）、非吸烟者状态（女性 27.4% vs. 男性 17.1%；p<0.001）、种族（混血儿/土著人 35.3% vs. 高加索人 13.7%；p<0.001）和无 KRAS 突变（女性 38.1% vs. 男性 4.7%；p<0.001）独立相关。EGFR 酪氨酸激酶抑制剂的总体缓解率为 60.6%（95%CI，52-69），无进展生存期和总生存期的中位数分别为 15.9 个月（95%CI，12.4-0.6）和 32 个月（95%CI，26.5-37.6）。