Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas

Mimi Ceppa, Mark G. Kris, Gregory J. Riely, Inderpal S. Sarkaria, Tiffani McDonough, Shaokun Chuai, Ennapadam S. Venkatraman, Vincent A. Miller, Marc Ladanyi, William Pao, Richard K. Wilson, Bhuvanesh Singh, Valerie W. Rusch

Research output: Contribution to journalArticle

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Abstract

Purpose: Lung adenocarcinomas with mutations in exons 19 and 21 of the epidermal growth factor receptor gene (EGFR) demonstrate sensitivity to gefitinib or erlotinib. Investigators have reported an association between EGFR mutations and the amount and duration of cigarette smoking, with the highest incidence of mutations seen in never smokers. Methods: EGFR exon 19 and 21 mutation status was determined in 265 tumor samples using direct sequencing, polymerase chain reaction (PCR), or PCR-based restriction fragment length polymorphism analysis. A detailed smoking history was obtained. Patients were categorized as never smokers (<100 lifetime cigarettes), former smokers (quit ≥ 1 year ago), or current smokers (quit <1 year ago). Results: We detected EGFR mutations in 34 (51%) of 67 never smokers (95% CI, 38% to 64%), 29 (19%) of 151 former smokers (95% CI, 13% to 27%), and two (4%) of 47 current smokers (95% CI, 1% to 16%). Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P <.001) or stopped smoking less than 25 years ago (P <.02) compared with individuals who never smoked. The number of smoking pack-years and smoke-free years predicted the prevalence of EGFR mutations (areas under receiver operating characteristic curve = 0.78 and 0.77, respectively). Conclusion: The likelihood of EGFR mutations in exons 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 25 years ago. These data can assist clinicians in assessing the likelihood of exon 19 and 21 EGFR mutations in patients with lung adenocarcinoma when mutational analysis is not feasible.

Original languageEnglish (US)
Pages (from-to)1700-1704
Number of pages5
JournalJournal of Clinical Oncology
Volume24
Issue number11
DOIs
StatePublished - Apr 10 2006
Externally publishedYes

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erbB-1 Genes
Exons
Smoking
History
Mutation
Adenocarcinoma of lung
Polymerase Chain Reaction
ROC Curve
Smoke
Tobacco Products
Restriction Fragment Length Polymorphisms
Research Personnel

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas. / Ceppa, Mimi; Kris, Mark G.; Riely, Gregory J.; Sarkaria, Inderpal S.; McDonough, Tiffani; Chuai, Shaokun; Venkatraman, Ennapadam S.; Miller, Vincent A.; Ladanyi, Marc; Pao, William; Wilson, Richard K.; Singh, Bhuvanesh; Rusch, Valerie W.

In: Journal of Clinical Oncology, Vol. 24, No. 11, 10.04.2006, p. 1700-1704.

Research output: Contribution to journalArticle

Ceppa, M, Kris, MG, Riely, GJ, Sarkaria, IS, McDonough, T, Chuai, S, Venkatraman, ES, Miller, VA, Ladanyi, M, Pao, W, Wilson, RK, Singh, B & Rusch, VW 2006, 'Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas', Journal of Clinical Oncology, vol. 24, no. 11, pp. 1700-1704. https://doi.org/10.1200/JCO.2005.04.3224
Ceppa, Mimi ; Kris, Mark G. ; Riely, Gregory J. ; Sarkaria, Inderpal S. ; McDonough, Tiffani ; Chuai, Shaokun ; Venkatraman, Ennapadam S. ; Miller, Vincent A. ; Ladanyi, Marc ; Pao, William ; Wilson, Richard K. ; Singh, Bhuvanesh ; Rusch, Valerie W. / Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas. In: Journal of Clinical Oncology. 2006 ; Vol. 24, No. 11. pp. 1700-1704.
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title = "Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas",
abstract = "Purpose: Lung adenocarcinomas with mutations in exons 19 and 21 of the epidermal growth factor receptor gene (EGFR) demonstrate sensitivity to gefitinib or erlotinib. Investigators have reported an association between EGFR mutations and the amount and duration of cigarette smoking, with the highest incidence of mutations seen in never smokers. Methods: EGFR exon 19 and 21 mutation status was determined in 265 tumor samples using direct sequencing, polymerase chain reaction (PCR), or PCR-based restriction fragment length polymorphism analysis. A detailed smoking history was obtained. Patients were categorized as never smokers (<100 lifetime cigarettes), former smokers (quit ≥ 1 year ago), or current smokers (quit <1 year ago). Results: We detected EGFR mutations in 34 (51{\%}) of 67 never smokers (95{\%} CI, 38{\%} to 64{\%}), 29 (19{\%}) of 151 former smokers (95{\%} CI, 13{\%} to 27{\%}), and two (4{\%}) of 47 current smokers (95{\%} CI, 1{\%} to 16{\%}). Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P <.001) or stopped smoking less than 25 years ago (P <.02) compared with individuals who never smoked. The number of smoking pack-years and smoke-free years predicted the prevalence of EGFR mutations (areas under receiver operating characteristic curve = 0.78 and 0.77, respectively). Conclusion: The likelihood of EGFR mutations in exons 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 25 years ago. These data can assist clinicians in assessing the likelihood of exon 19 and 21 EGFR mutations in patients with lung adenocarcinoma when mutational analysis is not feasible.",
author = "Mimi Ceppa and Kris, {Mark G.} and Riely, {Gregory J.} and Sarkaria, {Inderpal S.} and Tiffani McDonough and Shaokun Chuai and Venkatraman, {Ennapadam S.} and Miller, {Vincent A.} and Marc Ladanyi and William Pao and Wilson, {Richard K.} and Bhuvanesh Singh and Rusch, {Valerie W.}",
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T1 - Use of cigarette-smoking history to estimate the likelihood of mutations in epidermal growth factor receptor gene exons 19 and 21 in lung adenocarcinomas

AU - Ceppa, Mimi

AU - Kris, Mark G.

AU - Riely, Gregory J.

AU - Sarkaria, Inderpal S.

AU - McDonough, Tiffani

AU - Chuai, Shaokun

AU - Venkatraman, Ennapadam S.

AU - Miller, Vincent A.

AU - Ladanyi, Marc

AU - Pao, William

AU - Wilson, Richard K.

AU - Singh, Bhuvanesh

AU - Rusch, Valerie W.

PY - 2006/4/10

Y1 - 2006/4/10

N2 - Purpose: Lung adenocarcinomas with mutations in exons 19 and 21 of the epidermal growth factor receptor gene (EGFR) demonstrate sensitivity to gefitinib or erlotinib. Investigators have reported an association between EGFR mutations and the amount and duration of cigarette smoking, with the highest incidence of mutations seen in never smokers. Methods: EGFR exon 19 and 21 mutation status was determined in 265 tumor samples using direct sequencing, polymerase chain reaction (PCR), or PCR-based restriction fragment length polymorphism analysis. A detailed smoking history was obtained. Patients were categorized as never smokers (<100 lifetime cigarettes), former smokers (quit ≥ 1 year ago), or current smokers (quit <1 year ago). Results: We detected EGFR mutations in 34 (51%) of 67 never smokers (95% CI, 38% to 64%), 29 (19%) of 151 former smokers (95% CI, 13% to 27%), and two (4%) of 47 current smokers (95% CI, 1% to 16%). Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P <.001) or stopped smoking less than 25 years ago (P <.02) compared with individuals who never smoked. The number of smoking pack-years and smoke-free years predicted the prevalence of EGFR mutations (areas under receiver operating characteristic curve = 0.78 and 0.77, respectively). Conclusion: The likelihood of EGFR mutations in exons 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 25 years ago. These data can assist clinicians in assessing the likelihood of exon 19 and 21 EGFR mutations in patients with lung adenocarcinoma when mutational analysis is not feasible.

AB - Purpose: Lung adenocarcinomas with mutations in exons 19 and 21 of the epidermal growth factor receptor gene (EGFR) demonstrate sensitivity to gefitinib or erlotinib. Investigators have reported an association between EGFR mutations and the amount and duration of cigarette smoking, with the highest incidence of mutations seen in never smokers. Methods: EGFR exon 19 and 21 mutation status was determined in 265 tumor samples using direct sequencing, polymerase chain reaction (PCR), or PCR-based restriction fragment length polymorphism analysis. A detailed smoking history was obtained. Patients were categorized as never smokers (<100 lifetime cigarettes), former smokers (quit ≥ 1 year ago), or current smokers (quit <1 year ago). Results: We detected EGFR mutations in 34 (51%) of 67 never smokers (95% CI, 38% to 64%), 29 (19%) of 151 former smokers (95% CI, 13% to 27%), and two (4%) of 47 current smokers (95% CI, 1% to 16%). Significantly fewer EGFR mutations were found in people who smoked for more than 15 pack-years (P <.001) or stopped smoking less than 25 years ago (P <.02) compared with individuals who never smoked. The number of smoking pack-years and smoke-free years predicted the prevalence of EGFR mutations (areas under receiver operating characteristic curve = 0.78 and 0.77, respectively). Conclusion: The likelihood of EGFR mutations in exons 19 and 21 decreases as the number of pack-years increases. Mutations were less common in people who smoked for more than 15 pack-years or who stopped smoking cigarettes less than 25 years ago. These data can assist clinicians in assessing the likelihood of exon 19 and 21 EGFR mutations in patients with lung adenocarcinoma when mutational analysis is not feasible.

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