Frequency of EGFR mutations and associated clinical factors in Thai patients with non-small cell lung cancer (NSCLC)

Chaichana Chantharakhit; Wanfasai  Chantharapha; Suwijak  Teeramit; Tanyanat  Kongket; Apichaya  Wanwaisart; Poonyisa  Praevijitr; Oratai  Wongsuwan; Savita  Puttipaisal

Authors

Chaichana Chantharakhit Department of Internal Medicine, Buddhasothorn Hospital, Thailand https://orcid.org/0000-0003-4859-7611
Wanfasai Chantharapha Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Suwijak Teeramit Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Tanyanat Kongket Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Apichaya Wanwaisart Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Poonyisa Praevijitr Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Oratai Wongsuwan Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand
Savita Puttipaisal Medical Education Center, Buddhasothorn Hospital, Faculty of Medicine, Thammasat University, Thailand

Keywords:

epidermal growth factor receptor, EGFR, non-small cell lung cancer, NSCLC, Thai, clinical factors

Abstract

Objective Understanding clinical factors related to epidermal growth factor receptor (EGFR) mutation in lung cancer patients is imperative for effective treatment planning. It is also crucial to recognize ethnic differences. Hence, studying the prevalence and types of EGFR mutations in Thai patients with non-small cell lung cancer (NSCLC) is essential. Investigating clinical factors influencing EGFR mutation detection remains critical.

Methods Etiognostic research with a retrospective observational cohort design collected clinical data from NSCLC patients undergoing EGFR molecu-lar testing using real-time PCR from November 1, 2017 to September 30, 2022. The relationship between smoking as well as other clinical factors of interest and the detection of EGFR mutation through regression were analyzed.

Results The EGFR mutation rate was 46.55%, with 108 cases detected out of 232 patients. EGFR mutation was detected in 63.41% of the never smoking group. Exon 19 deletion (51.85%) and exon 21 L858R mutation (36.11%) were the predominant types. Univariable regression analysis identified factors correlated with EGFR mutation detection, including female gender, non-smoker status, adenocarcinoma lung cancer type, and bone metastasis. A statistically significant reduction in EGFR mutation detection was observed in patients with squamous cell carcinoma lung cancer. Multivariable regression analysis confirmed non-smoker and adenocarcinoma lung cancer type as significant independent predictors of EGFR mutation detection (adjusted OR 2.84, 95%CI 1.20-6.74, p = 0.018) (adjusted OR 14.39, 95%CI 1.77-116.84, p = 0.013), respectively. The survival analysis results showed significant survival differences between stage 4 NSCLC patients with EGFR mutations and EGFR wild-type (median overall survival: 22.98 months vs 8.72 months, median survival time difference: 12.60 months, p < 0.001).

Conclusions Adenocarcinoma and non-smoker status represent significant factors associated with EGFR mutation. Nonetheless, performing an EGFR test before initiating treatment remains crucial as it enhances treatment precision and specificity.

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