24419415
BACKGROUND	In non-small-cell lung cancer , an exon 19 deletion and an L858R point mutation in the epidermal growth factor receptor ( EGFR ) are predictors of a response to EGFR-tyrosine kinase inhibitors .
BACKGROUND	However , it is uncertain whether other uncommon EGFR mutations are associated with sensitivity to EGFR-tyrosine kinase inhibitors .
METHODS	A post-hoc analysis to assess prognostic factors was performed with the use of patients with EGFR mutations ( exon 19 deletion , L858R , G719X , and L861Q ) who were treated with gefitinib in the NEJ002 study , which compared gefitinib with carboplatin-paclitaxel as the first-line therapy .
RESULTS	In the NEJ002 study , 225 patients with EGFR mutations received gefitinib at any treatment line .
RESULTS	The Cox proportional hazards model indicated that performance status , response to chemotherapy , response to gefitinib , and mutation types were significant prognostic factors .
RESULTS	Overall survival ( OS ) was significantly shorter among patients with uncommon EGFR mutations ( G719X or L861Q ) compared with OS of those with common EGFR mutations ( 12 versus 28.4 months ; p = 0.002 ) .
RESULTS	In the gefitinib group ( n = 114 ) , patients with uncommon EGFR mutations had a significantly shorter OS ( 11.9 versus 29.3 months ; p < 0.001 ) .
RESULTS	By contrast , OS was similar between patients with uncommon mutations and those with common mutations in the carboplatin-paclitaxel group ( n = 111 ; 22.8 versus 28 months ; p = 0.358 ) .
CONCLUSIONS	The post-hoc analyses clearly demonstrated shorter survival for gefitinib-treated patients with uncommon EGFR mutations compared with the survival of those with common mutations and suggest that the first-line chemotherapy may be relatively effective for non-small-cell lung cancer with uncommon EGFR mutations .

