Coexistence of p16/CDKN2A homozygous deletions and activating EGFR mutations in lung adenocarcinoma patients signifies a poor response to EGFR-TKIs. (December 2016)

• Record Type: Journal Article
• Authors: Jiang, Juhong; Gu, Yingying; Liu, Jing; Wu, Ruibin; Fu, Lin; Zhao, Jin; Guan, Yubao
• Is Part Of: Lung cancer. Volume 102(2016)
• Page Start: 101
• Page End: 107
• Publication Date: 2016-12
• Subjects: Lung adenocarcinoma -- EGFR-TKI -- p16/CDKN2A -- Homozygous deletion; Lungs -- Cancer -- Periodicals; Lung Neoplasms -- Abstracts; Lung Neoplasms -- Periodicals; Poumons -- Cancer -- Périodiques; Lungs -- Cancer; Periodicals; Electronic journals; Electronic journals; 616.99424
• DOI: 10.1016/j.lungcan.2016.10.015
• Languages: English
• ISSNs: 0169-5002

Abstract

Highlights: P16 HDs were detected in 24.4% of lung adenocarcinomas before EGFR-TKI therapy. P16 HDs correlated with a shorter median PFS in response to EGFR-TKIs. P16 HDs may predict response to EGFR-TKI therapy in lung adenocarcinoma patients. Abstract: Objectives: Activating mutations in the epidermal growth factor receptor (EGFR) are strongly predictive of EGFR-tyrosine kinase inhibitor (TKI) activity in non-small cell lung cancer (NSCLC). However, primary resistance to EGFR-TKIs occurs in approximately 20–30% of NSCLC patients with EGFR mutations. The goal of this study was to determine whether p16/CDKN2A homozygous deletion (HD) is associated with primary resistance to EGFR-TKIs in lung adenocarcinoma patients with EGFR activating mutations. Methods: We investigated 127 patients with stage IIIB or IV lung adenocarcinoma harboring activating EGFR mutations, and who had received EGFR-TKIs as first-line therapy. Dual-color fluorescence in situ hybridization for p16/CDKN2A and chromosome 9 was performed in tumor biopsy samples obtained before initiation of EGFR-TKI treatment. Results: p16/CDKN2A HD was detected in 24.4% (31/127) of patients, and the overall response rate in patients with and without this mutation was 48.4% and 78.1%, respectively (P = 0.0027). The median progression-free survival was 5.3 months (95% confidence interval [CI]: 4.582–6.018) for patients with p16/CDKN2A HD and 10.5 months (95% CI: 9.365–11.635 months) for patients without the mutation (P = 0.001). No correlations between p16/CDKN2A HD and patient characteristics including gender, age, smoking history, EGFR mutation type, tumor-node-metastasis stage, and performance status were found. Conclusions: Our study demonstrates that the coexistence of p16/CDKN2A HDs and activating EGFR mutations in lung adenocarcinoma patients signifies a poor response to EGFR-TKI therapy.