Acta Medica Colombiana
Print version ISSN 0120-2448
OTERO, Jorge Miguel et al. Survival of advanced lung adenocarcinoma patients and report of the first epidermal growth factor receptor mutations recognized in Colombia ONCOLGroup study. Acta Med Colomb [online]. 2009, vol.34, n.2, pp. 55-65. ISSN 0120-2448.
Introduction: the incidence of lung adenocarcinoma increased by 100% since 1950. Methods: this study included 147 advanced lung adenocarcinoma (ALA) patients treated in Bogotá between 2000 and 2007. Overall response rates (ORR), clinical benefit (CB), time to progression (TTP) and overall survival (OS) were estimated. EGFR mutations were studied in a subgroup of patients. Results: mean age was 66±12.8 years. Seventy-eight patients were women, 40% had never been exposed to tobacco smoke and performance status (PS) was = 70% in 119 patients. The brain was the dominant site for metastasis followed by the lungs. Sixty-nine percent of the patients received a platinum doublet as first-line intervention and 32 patients (22%) had received erlotinib as part of their treatment. Response to first-line treatment was available in 110 patients; ORR was 28%, CB 39% and TTP 3.7 months (0.6-18.2). Second-line therapy was administered to 46 patients; ORR was 8%, CB 25% and TTP 3.7 months (2.1-17). Median OS was 9.8 months (6.3-19) and the PS, absence of tobacco exposure, and administration of erlotinib, positively influenced this outcome. EGFR mutational profile was assessed in 10 highly-selected patients; four presented mutations in exon (E) 19 (two patients had a 3 serine-rich nucleotide insertion (L747_S750) which has not been previously reported) and two presented the E21 mutation (L858R). For this subgroup, ORR to erlotinib was 85% and in 5 cases the survival was greater than 16-months. Conclusions: outcomes for patients suffering from ALA in Colombia are similar to those described in other Latin American countries. Six patients with EGFR alterations were identified in this cohort.
Keywords : non-small cell lung cancer; adenocarcinoma; survival; chemotherapy; epidermal growth factor receptor; mutation.