Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation

  • Bulent Erdogan Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Hilmi Kodaz Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Senem Karabulut Department of Medical Oncology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
  • Ahmet Cinkaya Department of Radiation Oncology, Dumlupınar University, Kutahya, Turkey
  • Hilmi Tozkir Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
  • Ozgur Tanriverdi Department of Medical Oncology, Education and Research Hospital, Mugla Sıtkı Kocman University, Mugla, Turkey
  • Devrim Cabuk Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey https://orcid.org/0000-0002-7871-6311
  • Muhammed Bekir Hacioglu Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey https://orcid.org/0000-0001-8490-3239
  • Esma Turkmen Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey https://orcid.org/0000-0003-1803-2409
  • Ilhan Hacibekiroglu Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey https://orcid.org/0000-0002-0333-7405
  • Sernaz Uzunoglu Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey https://orcid.org/0000-0001-5387-8309
  • Irfan Cicin Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Keywords: Lung adenocarcinoma, epidermal growth factor receptor, smoking

Abstract

Lung cancer in smokers and non-smokers demonstrates distinct genetic profiles, and cigarette smoking affects epidermal growth factor receptor (EGFR) function and causes secondary EGFR tyrosine kinase resistance. We evaluated the effect of active smoking in patients with metastatic lung adenocarcinoma. A total of 132 metastatic lung adenocarcinoma patients, diagnosed between 2008 and 2013, with known EGFR mutation status, were evaluated retrospectively. Among these patients, 40 had an activating EGFR mutation. Patients who continued smoking during the treatment were defined as active smokers. Former smokers and never smokers were together defined as non-smokers. The outcomes of the treatment in relation to the EGFR mutation and smoking status were evaluated. The median follow-up time was 10.5 months. The overall response rate for the first-line therapy was significantly higher among the EGFR-mutant patients (p = 0.01), however, smoking status had no impact on the response rate (p = 0.1). The EGFR-mutant active smokers progressed earlier than the non-smokers (p < 0.01). The overall survival (OS) of the non-smokers and patients treated with erlotinib was significantly longer (p = 0.02 and p = 0.01, respectively). Smoking status did not affect the OS in EGFR wild type tumors (p = 0.49) but EGFR-mutant non-smokers had a longer OS than the active smokers (p = 0.01).The active smokers treated with erlotinib had poorer survival than the non-smokers (p = 0.03). Multivariate analysis of EGFR-mutant patients showed that erlotinib treatment at any line and non-smoking were independent prognostic factors for the OS (p = 0.04 and p = 0.01, respectively). Smoking during treatment is a negative prognostic factor in metastatic lung adenocarcinoma with an EGFR mutation.

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Author Biographies

Bulent Erdogan, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Hilmi Kodaz, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Senem Karabulut, Department of Medical Oncology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
Department of Medical Oncology
Ahmet Cinkaya, Department of Radiation Oncology, Dumlupınar University, Kutahya, Turkey
Department of Radiation Oncology
Hilmi Tozkir, Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Genetics
Ozgur Tanriverdi, Department of Medical Oncology, Education and Research Hospital, Mugla Sıtkı Kocman University, Mugla, Turkey
Department of Medical Oncology
Devrim Cabuk, Department of Medical Oncology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
Department of Medical Oncology
Muhammed Bekir Hacioglu, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Esma Turkmen, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Ilhan Hacibekiroglu, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Sernaz Uzunoglu, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology
Irfan Cicin, Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne, Turkey
Department of Medical Oncology

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Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation
Published
2016-11-10
How to Cite
1.
Erdogan B, Kodaz H, Karabulut S, Cinkaya A, Tozkir H, Tanriverdi O, Cabuk D, Hacioglu MB, Turkmen E, Hacibekiroglu I, Uzunoglu S, Cicin I. Impact of active smoking on survival of patients with metastatic lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) mutation. Bosn J of Basic Med Sci [Internet]. 2016Nov.10 [cited 2019Nov.14];16(4):280-5. Available from: http://bjbms.org/ojs/index.php/bjbms/article/view/1380
Section
Translational and Clinical Research

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