Treatment of Patients With Non-small-cell Lung Cancer With Uncommon <i>EGFR</i> Mutations in Clinical Practice
Yutaka Yamada, Tomohiro Tamura, Yusuke Yamamoto, Hideo Ichimura, Kenji Hayashihara, Takefumi Saito, Hideyasu Yamada, Takeo Endo, Ryota Nakamura, Yoshihisa Inage, Hiroaki Satoh, Kesato Iguchi, Kazuto Saito, Masaharu Inagaki, Norihiro Kikuchi, Koichi Kurishima, Hiroichi Ishikawa, Mitsuaki Sakai, Koichi Kamiyama, Toshihiro Shiozawa, Nobuyuki Hizawa, Ikuo Sekine, Yukio Sato, Yasunori Funayama, Kunihiko Miyazaki, Takahide Kodama, SHIGEN HAYASHI, Akihiro Nomura, Hiroyuki Nakamura, Kinya Furukawa, Takaaki Yamashita, Hatsumi Okubo, Hisashi Suzuki, Moriyuki Kiyoshima, Takayuki Kaburagi
Abstract
BACKGROUND/AIM: To describe real clinical outcomes in patients with non-small cell lung cancer who have uncommon epidermal growth factor receptor (EGFR) mutations. MATERIALS AND METHODS: We performed a retrospective chart review from 15 medical institutes that cover a population of three million people from April 2008 to March 2019. RESULTS: There were 102 patients with uncommon EGFR mutation. Progression-free survival (PFS) tended to be longer in patients receiving afatinib compared with first-generation EGFR tyrosine kinase inhibitors. PFS in patients treated with afatinib or osimertinib was significantly longer than in patients treated with gefitinib or erlotinib (p=0.030). Multivariate analysis also revealed the contribution of afatinib or osimertinib to increased survival. In patients with exon 20 insertions, chemotherapy was efficacious. CONCLUSION: In treating patients with uncommon EGFR mutations, our results indicate longer-term survival might be achieved with second-generation or later TKIs and cytotoxic chemotherapeutic drugs.