Objective: This study analyzed the relationship between the clinicopathological features and epidermal growth factor receptor (EGFR ) mutation status of squamous cell lung cancer (SqCLC) patients. Mutation status was analyzed by comparing the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) and next-generation sequencing (NGS). We also assessed the efficacies of EGFR tyrosine kinase inhibitors (TKIs).
Methods: Retrospective analysis was performed for 292 SqCLC patients treated at the Guangxi Medical University Affiliated Tumor Hospital from December 2013 to December 2018. The EGFR  mutations in tumor tissues were identified by ARMS-PCR and NGS. The affiliation between EGFR  mutation and clinicopathological features was analyzed. Efficacies of EGFR-TKIs and survival were evaluated using the benchmarks of response evaluation criteria in solid tumors 1.1 (RECIST 1.1) and the Kaplan–Meier method, respectively.
Results: Among the 292 SqCLC patients, 24 (8.2%) were identified to have an EGFR -sensitizing mutation. Both ARMS-PCR and NGS were equally effective in detecting EGFR  mutations. Females and non-smokers had higher EGFR  mutation rates than males and smokers (22.1% vs. 5.1%, P  = 0.007 and 16.7% vs. 4.5%, P  = 0.001, respectively). EGFR  mutation was unrelated to the degree of differentiation, clinical stage, specimen type and level of serum carcino-embryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) (P  > 0.05). In the 14 EGFR  mutant cases treated with EGFR-TKIs, the objective response rate (ORR) and disease control rate (DCR) were 28.6% and 78.6%, respectively. Median progression-free survival (mPFS) and overall survival (mOS) were 4.9 and 10.75 months, respectively, with fine tolerance and mild side-effects.
Conclusion: EGFR -sensitizing mutations are rare in SqCLC patients with females and non-smokers having a higher risk of harboring them. There was no difference in the detection rates of EGFR  for both the ARMS-PCR and NGS methods. EGFR-TKIs showed modest efficacies and low toxicity profiles in EGFR  mutant cases.
Keywords: squamous cell lung carcinoma, epidermal growth factor receptor mutation, clinicopathologic features, tyrosine kinase inhibitors