Brain Tumor Res Treat.  2019 Oct;7(2):137-140. 10.14791/btrt.2019.7.e44.

Discordance of Epidermal Growth Factor Receptor Mutation between Brain Metastasis and Primary Non-Small Cell Lung Cancer

Affiliations
  • 1Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
  • 2Department of Neurosurgery, Eulji University Hospital, Daejeon, Korea.
  • 3Department of Internal Medicine, Eulji University Hospital, Daejeon, Korea.
  • 4Department of Cancer Control, National Cancer Center Hospital, Goyang, Korea.
  • 5Neuro-Oncology Clinic, National Cancer Center Hospital, Goyang, Korea. heonyoo@ncc.re.kr

Abstract

BACKGROUND
The aim of this study was to compare epidermal growth factor receptor (EGFR) mutations between non-small cell lung cancer (NSCLC) and corresponding brain metastases (BMs) in Korea society.
METHODS
From 2011 to 2016, a total of 74 patients underwent surgical resection of a metastatic brain tumor from NSCLC. Among them, we performed retrospective analysis for 46 patients who underwent EGFR sequencing of primary NSCLC tissues.
RESULTS
Among these 46 cases, 18 (39.1%) cases showed EGFR mutation in primary lung cancer. Detected mutation sites were exon 19 (8 cases), exon 21 (6 cases), exon 18 (1 cases), and multiple mutations (3 cases). In 18 cases of BM, EGFR mutation studies were done. Among them, 8 (25.6%) cases showed mutation on exon 19 (5 cases) or exon 21 (3 cases). To compare EGFR mutation status between primary lung cancer and BM, 18 paired tissues from both NSCLC and matched BM were collected. Four (22.5%) patients were discordant for the status of EGFR between primary and metastatic sites.
CONCLUSION
EGFR mutations were significantly discordant between primary tumors and corresponding metastases in a significant portion of NSCLC. In treatment of BM of EGFR mutant metastatic NSCLC, due to possibility of discordance, pathologic confirming through brain biopsy is recommended.

Keyword

Metastasis; Lung cancer; Mutation; Epidermal growth factor receptor

MeSH Terms

Biopsy
Brain Neoplasms
Brain*
Carcinoma, Non-Small-Cell Lung*
Epidermal Growth Factor*
Exons
Humans
Korea
Lung Neoplasms
Neoplasm Metastasis*
Receptor, Epidermal Growth Factor*
Retrospective Studies
Epidermal Growth Factor
Receptor, Epidermal Growth Factor
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