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Epidermal growth factor receptor (EGFR) positive non-small-cell lung carcinoma (NSCLC) patients in the Gulf region: current status, challenges, and call for action


Journal of Cancer Prevention & Current Research
Hassan Jaafar,1 Ahmed Mohieldin,2 Reyad Mohsen,3 Abdulaziz Al Farsi,4 Aladdin Maarraoui,5 Muath Al-Nassar,2 Trad Diaeddine,6 Dalia El Shourbagy,7 Emad Anwar Dawoud6

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Abstract

Background: Baseline epidemiology information specific to the region is important to guide disease management. However, data and publication with focus on in-patient populations with advanced stage epidermal growth factor receptor (EGFR) positive non-small-cell lung carcinoma (NSCLC) across the Gulf is limited.

Methods: Epidemiology data of various hospital centers from four Gulf nations (United Arab Emirates, Kuwait, Oman and Qatar) were provided by the esteemed panel of experts. Data related to prevalence of newly diagnosed cases, EGFR mutation rates, demographics associated with the mutations, type of mutation testing administered, and management with anti-EGFR therapy agent were collected and analyzed.

Results: From 2014 to 2016, a total of 17,026 newly diagnosed cancer cases were reported in the region, with lung cancer present in 5.7% of the confirmed cases. Advanced stage lung cancer cases were diagnosed in 76% of these patients. The EFGR mutation prevalence in the region was at 36.9%. Among the EGFR positive cases that progressed on anti-EGFR therapy, only 46% of the cases were tested for T790M mutations. The substantial lack of testing data, highlights either a potential need for routine mutation testing or identification of a standard of care for NSCLC cases harboring a T790M mutation. 

Conclusion: Results showed a high prevalence of EGFR positive lung cases in the region despite the low incidence rate of subsequent molecular testing. Recommendations from the expert panel include the implementation of prospective observation trial and use of novel agents, such as osimertinib, as standard anti-EGFR therapy when biomarker testing is challenged.

Keywords

epidemiology, epidermal growth factor receptor mutations, gulf, non-small cell lung cancer, T7, heterogeneous group, pulmonary malignancies, histology, non-smokers, tyrosine kinase, patients, EGFR testing, epidermal growth factor receptors, kinase inhibitors, substantial data, epidemiological landscape

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