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The EGFR and KRAS Mutation Status and Correlations with the Prevalence of Bone Metastases - The Results of Three Year Retrospective Analysis
Nora Bittner, Zoltan Baliko, Veronika Sarosi, Terezia Laszlo, Zoltan Szentirmay, Erika Tóth, Lajos Geczi and Miklós Kasler
Lung cancer is the leading cause of cancer related mortality all over the world. The development of molecular pathology methods has become increasingly important in the prediction of chemotherapy sensitivity and mutation analysis to identify driver mutations as important targets of new therapeutic agents. These agents give an opportunity to provide a new standard of care. Therefore testing EGFR, KRAS mutations and ALK rearrangements in patients with advanced lung adenocarcinoma should be incorporated into routine clinical practice. Bone is the most frequent type of distant metastases in case of Non-Small Cell Lung Cancer (NSCLC). During the disease this is developing 30-40%. Because of the short survival (6 months) the treatment possibilities were not in the aim of scope. After the changes of treatment guidelines – first the platinum based chemotherapy, later the step of EGFR TK inhibitors therapy – the Overall Survival (OS) became more longer. The relevant clinical studies concluded that: bone metastases and Skeletal Related Events (SRE) are more frequently observed in men, heavy smokers and without treatment of EGFR TK inhibitors. In our retrospective study we collected 224 most relevant clinical data patient with lung adenocarcinoma. We investigated the correlations between the EGFR, KRAS mutations status and the prevalence of bone metastases and survival. We have found that EGFR and KRAS mutation status are both predictive factors for the treatment efficacy and are prognostic factors for the disease progression but these are not predictors of the presence of bone metastases. The presence of bone metastases is an independent prognostic marker what correlates with the poor performance and worse Quality of Life (QL).