Özet:

Aim: To present our experience in EGFR and EML-4/ALK-mutated lung adenocarcinoma patients. Material and Methods: 2580 patients were retrospectively evaluated. Only stage-4 lung adenocarcinoma patients who treated with at least 2-cycles of platinum-based regimens at frontline were included. Results: Among 105 eligible patients, EGFR and EML-4/ALK mutations was detected in 14 and 4 patients. 75 were wild- type for both mutations. The median age and age of diagnose was 61 and 58.5, respectively. 81% was male and 78% was smoker. EGFR and EML-4/ALK-mutant patients were predominantly female and non-smoker (EGFR; p=0.025 and 0.002, EML-4/ALK; p=0.003 and 0.012,respectively). EML-4/ALK- mutant patients were significantly younger than EML- 4/ALK wild-type (p=0.02) (Table 1). EGFR exon-19, 20 and 21 mutations were associated with liver, bone and pleural metastases, respectively (p=0.046, 0.05 and 0.035,respectively). After firstline platinum-based chemotherapy, complete remission (CR) and partial remission (PR) rates were 4.7% and 24.6%,respectively. Concurrent radiotherapy and absence of bone metastases at diagnosis were significant factors influencing firstline platinum-based therapy responses (p=0.004 and p=0.046,respectively). EGFR or EML-4/ALK mutation status didn’t show significant difference in terms of platinum- based treatment response (p=0.933 and 0.184,respectively). Median progression-free survival (PFS) was 10 months. The observed effect of concurrent radiotherapy and the presence of bone metastases on treatment response didn’t reflected in the PFS results (p=0.079 and 0.285,respectively). Conclusion: The presence of EGFR and ALK mutations does not effect the treatment response of platinum-based regimens. The association of EGFR exon subsets with metastasis points is worth investigating.

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