Epidermal Growth Factor Mutation Analysis in Patients With Bronchogenic Adenocarcinoma: Prevalence and Clinical Profile-Outlook From a Tertiary Care Center in India.

Introduction Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients as it is now recognized both as a prognostic and predictive marker for therapy with EGFR tyrosine kinase inhibitors (TKIs). The data on the prevalence of mutation and its clinical profile in bronchogenic adenocarcinoma are vastly available from Eastern Asian and European countries. The frequency of EGFR mutations in India however remains sparsely explored. Activating EGFR mutations in the tyrosine kinase region have been shown to underlie response to these inhibitors. However, the frequency of EGFR mutations and their clinical response in most other ethnic populations, including India, remains to be explored. In addition to providing information on the stage of the disease and the Eastern Cooperative Oncology Group (ECOG) performance scale at presentation, this is one of the rare studies from the subcontinent where EGFR mutation was performed in a single laboratory using a standardized procedure. The aims and objectives of the study are to estimate the prevalence of EGFR gene mutation in adenocarcinoma of the lung and to assess the clinical profile that correlates with EGFR gene status. Material and methods This single-center-based cross-sectional study was conducted at R.L. Jalappa Hospital, Kolar, India, over eight months (October 2023 to June 2024). The study included patients diagnosed with NSCLC adenocarcinoma whose participation was secured through informed consent. These tissues had been tested for EGFR mutational status. EGFR mutation analysis will be done on extracted DNA with real-time polymerase chain reaction to estimate the prevalence of EGFR mutation in adenocarcinoma of the lung. All data were entered in a Microsoft Excel sheet (Redmond, WA, USA) and statistical analysis will be performed using SPSS statistics for Windows, Version 22.0 (IBM Corp., Armonk, NY). Categorical data were represented in the form of frequencies and proportions. To check the association between qualitative data, Chi-square was applied with a level of significance defined as a p-value < 0.05. Continuous data was represented as mean and standard deviation. Results Of the 61 patients included in the study, the mean age of prevalence of EGFR mutation in adenocarcinoma was 58.13 years, with a prevalence rate of 31.1%. EGFR mutation was positive in 11 (42.3%) females and eight (22.8%) males. The prevalence of exon 19 deletion was the most common and was higher in females (seven (26.4%)) compared to males (eight (22.9%)). However, among those with an ECOG score of 3, one (2.3%) had EXON 18 G719S G719A G719C, and 14 (31.8%) had EXON 19 deletion. There was a significant difference (p-value<0.008) in the type of mutations concerning the ECOG performance scale. Conclusion The prevalence of activating EGFR mutations and their clinical correlations in our study are comparable with those previously published and Indian patients with EGFR mutations. In line with data already available from previously published studies, EGFR mutation is also a common finding in patients with lung adenocarcinoma, especially among women, and the exon 19 deletion is the most common variation. Incorporating EGFR mutation testing into early diagnostic protocols remains crucial for optimizing treatment strategies and improving patient outcomes.