Heterogeneity of the EGFR mutation status between the primary tumor and metastatic lymph node and the sensitivity to EGFR tyrosine kinase inhibitor in non-small cell lung cancer

• Published in: Targeted oncology Vol. 8; no. 4; pp. 237 - 242
• Main Authors: Shimizu, Katsuhiko, Yukawa, Takuro, Hirami, Yuji, Okita, Riki, Saisho, Shinsuke, Maeda, Ai, Yasuda, Koichiro, Nakata, Masao
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01-12-2013; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomedicine; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - enzymology; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - pathology; Female; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - enzymology; Lung Neoplasms - genetics; Lung Neoplasms - pathology; Lymphatic Metastasis; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Mutation; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - enzymology; Neoplasm Recurrence, Local - pathology; Oncology; Original Research; Pneumology; Protein Kinase Inhibitors - therapeutic use; Quinazolines - therapeutic use; Receptor, Epidermal Growth Factor - antagonists & inhibitors; Receptor, Epidermal Growth Factor - genetics; Retrospective Studies; Tumors of the respiratory system and mediastinum; Epidermal growth factor receptor mutation; Metastatic lymph node; tyrosine kinase inhibitor; Non-small cell lung cancer; Lung disease; Lymph node; Respiratory disease; Tyrosine kinase inhibitor; Lung cancer; Malignant tumor; Metastasis; non-small cell lung carcinoma; EGFR tyrosine kinase inhibitor; Epidermal growth factor receptor; Heterogeneity; Growth factor receptor; Sensitivity; Primary; Bronchus disease; Genetics; Advanced stage; Mutation; Cancer
• ISSN: 1776-2596; 1776-260X
• DOI: 10.1007/s11523-012-0241-x

The purpose of this study was to clarify the distribution of epidermal growth factor receptor (
EGFR
) mutations between primary tumors (PT) and metastatic lymph node (MLN) in patients with resected non-small cell lung cancer (NSCLC) and to identify a better predictive marker of the response to
EGFR
tyrosine kinase inhibitor (EGFR-TKI). We conducted a retrospective review of the data of 70 lung cancer patients with lymph node metastasis who underwent surgical resection. Analysis to detect
EGFR
mutations was performed by a peptide nucleic acid–locked nucleic acid polymerase chain reaction clamp method.
EGFR
mutations were detected in 15.7 % of both the PT and MLN and in 14.3 % of the PT only. The response rate to EGFR-TKI tended to be higher in patients with
EGFR
mutations in the MLN, as all patients with
EGFR
mutations in the MLN showed disease control to treatment with EGFR-TKI. Our results demonstrated that the
EGFR
mutation status of MLN is a predictive marker of the response to EGFR-TKI therapy in patients with recurrent NSCLC after surgical resection.