US EPA

1978010 

Journal Article 

Frequency of EGFR and KRAS Mutations in Lung Adenocarcinomas in African Americans 

Reinersman, JM; Johnson, ML; Riely, GJ; Chitale, DA; Nicastri, AD; Soff, GA; Schwartz, A; Sima, CS; Ayalew, G; Lau, C; Zakowski, MF; Rusch, VW; Ladanyi, M; Kris, MG 

2011 

1 

Journal of Thoracic Oncology
ISSN: 1556-0864
EISSN: 1556-1380 

6 

1 

28-31 

English 

21107288 

10.1097/JTO.0b013e3181fb4fe2 

WOS:000285587800007 

http://://WOS:000285587800007
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Introduction: The detection of mutations in the epidermal
growth factor receptor (EGFR) gene, which predict sensitivity to treatment with EGFR tyrosine
kinase inhibitors, represents a major advance in the treatment of lung adenocarcinoma. KRAS
mutations confer resistance to EGFR-tyrosine kinase inhibitors. The prevalence of these mutations
in African American patients has not been thoroughly investigated. Methods: We collected
formalin-fixed, paraffin-embedded material from resected lung adenocarcinomas from African
American patients at three institutions for DNA extraction. The frequencies of EGFR exon 19
deletions, exon 21 L858R substitutions, and KRAS mutations in tumor specimens from African
American patients were compared with data in white patients (n = 476). Results: EGFR mutations
were detected in 23 of the 121 specimens from African American patients (19%, 95% confidence
interval [CI]: 13-27%), whereas KRAS mutations were found in 21 (17%, 95% CI: 12-25%). There was
no significant difference between frequencies of EGFR mutations comparing African American and
white patients, 19% versus 13% (61/476, 95% CI: 10-16%; p = 0.11). KRAS mutations were more
likely among whites, 26% (125/476, 95% CI: 23-30%; p = 0.04). Conclusions: This is the largest
study to date examining the frequency of mutations in lung adenocarcinomas in African Americans.
Although KRAS mutations were somewhat less likely, there was no difference between the
frequencies of EGFR mutations in African American patients, when compared with whites. These
results suggest that all patients with advanced lung adenocarcinomas should undergo mutational
analysis before initiation of therapy. 

EGFR mutation; KRAS; African Americans; Racial differences