Author(s)

Xiaoshun Shi^1*, Fuxi Huang^2*, Allen M. Chen^3,4, Zhuolin Wu⁵, Qianqian Huang⁶, Ying Liang¹, Qipeng Zhou⁷, Haiyun Mo⁸, Xiaoxiang Li¹, Jiexia Zhang¹

¹National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Department of Medicine, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
²Department of Oncology, Panyu Central Hospital, Cancer Institute of Panyu, Guangzhou, China.
³Department of Mathematics, University of California, Berkeley, USA.
⁴Mendel Genes Inc, Manhattan Beach, USA.
⁵Department of Biomedical Engineering, University of Minnesota, Twin Cities, USA.
⁶Department of Hospital Infection Control, Affiliated Cancer Hospital & Institute of Guangzhou Medical University, Guangzhou, China.
⁷Department of Respiratory Medicine, Shantou Central Hospital, Shantou, China.
⁸Department of Health Care, Maternal and Child Health Hospital of Haizhu District, Guangzhou, China.

Background: Emerging evidence indicates that chemotherapy for lung cancer may alter EGFR mutation status. However, whether chemotherapy as a firstline treatment may increase or reduce the frequency of EGFR mutations in NSCLC remains uncertain. Therefore, we conducted a meta-analysis to evaluate whether chemotherapy leads to altered EGFR mutation status. Methods: A systematic literature search was performed using the PubMed, OVID, Science Direct, Cochrane Library, and CNKI databases for studies on pre- and post-chemotherapy EGFR mutation status. Relevant studies documenting perichemotherapy EGFR mutation ratios were included. Analyses of pooled odds ratios (OR) were performed. Results: Six studies involving 656 patients were included in this meta-analysis. It was found that chemotherapy may alter EGFR status (OR = 1.93, 95% CI 1.05 - 3.56; p < 0.0001). No significant differences in EGFR mutation alterations were observed in terms of gender, smoking history, EGFR loci, or chemotherapy response in NSCLC patients. Conclusions: Chemotherapy may contribute to altered EGFR status. NSCLC patients with EGFR mutations might need to be considered for EGFR status redeterminations prior to second-line EGFR-TKI treatment or upon tumor recurrence after chemotherapy. Further randomized clinical trials should investigate the impact of neoadjuvant or first-line chemotherapy on EGFR mutation status in NSCLC patients.

EGFR Mutation, Chemotherapy, Non-Small Cell Lung Cancer, Me-ta-Analysis

Shi, X. , Huang, F. , Chen, A. , Wu, Z. , Huang, Q. , Liang, Y. , Zhou, Q. , Mo, H. , Li, X. and Zhang, J. (2017) The Impact of Chemotherapy on EGFR Mutation Status in Non-Small-Cell Lung Cancer: A Meta-Analysis. Open Journal of Genetics, 7, 117-129. doi: 10.4236/ojgen.2017.74010.