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Case Reports
. 2017 Apr 11;8(15):25323-25333.
doi: 10.18632/oncotarget.15831.

Epidemiological features of lung giant cell carcinoma and therapy for patients with EGFR mutations based on case reports and the surveillance, epidemiology, and end results (SEER) database

Shan-Shan Weng  1 , Ying Cao  1 , Xiu-Jun Tang  1 , Li-Zhen Zhu  1 , Yi-Nuo Tan  1 , Cai-Xia Dong  1 , Jia-Qi Chen  1 , Hong Shen  1 , Ying Yuan  1
Affiliations
Case Reports

Epidemiological features of lung giant cell carcinoma and therapy for patients with EGFR mutations based on case reports and the surveillance, epidemiology, and end results (SEER) database

Shan-Shan Weng et al. Oncotarget. .

Abstract

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the standard first line treatment for advanced non-small cell lung cancer (NSCLC) with sensitive EGFR mutations. Among NSCLC, giant cell carcinoma of the lung (GCCL) is a rare pathological subtype with poor prognosis, with no confirmed evidence about its epidemiological features or therapeutic efficiency of EGFR-TKIs. We present two advanced GCCLs with sensitive EGFR mutations, also collected the cases of GCCL from our hospital and the Surveillance, Epidemiology, and End Results (SEER) program. Kaplan-Meier methods and Cox proportional hazards modeling were used to perform the survival analyses. Both two cases of advanced GCCL with sensitive EGFR mutations benefited from EGFR-TKIs. Twelve GCCLs were recorded in our hospital from May 2006 to July 2015. GCCL is associated with males (83.3%) and smoking status (63.6%). The EGFR mutation rate was 40.0%. In SEER database, the total number of GCCLs was 184, 0.11% for all NSCLCs. In Kaplan-Meier analysis, the 5-year overall survival of GCCL patients was significantly lower than that of non-GCC NSCLC (16% and 19%; P<0.001), and it was confirmed in multivariate analysis. Further survival analyses indicated that male were more susceptible to GCCL and GCCL was prone to metastasize. Only age and M stage were independent prognostic factors for GCCL in the multivariate analysis. In conclusion, GCCL was an unfavorable prognostic factor and associated with males and metastasis. GCCL patients with sensitive EGFR mutations may also benefit from EGFR-TKI, we therefore recommend the evaluation of EGFR in the treatment of advanced GCCL.

Keywords: EGFR; EGFR-TKIs; lung giant cell carcinoma.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors disclose no potential conflicts of interest.

Figures

Figure 1
Figure 1. Chest computed tomography of the patient (case 1) before and after gefitinib
(A) tumor mass in right lung on Mar 24th, 2015 (before gefitinib): (B) tumor mass in right lung on Apr 22th, 2015 (one month after gefitinib).
Figure 2
Figure 2. Chest computed tomography of the patient (case 1) before and after gefitinib
(A) lymph node metastasis in lung hilum and mediastinum on Mar 24th, 2015 (before gefitinib); (B) lymph nodes shrinking on Apr 22th, 2015 (one month after gefitinib).
Figure 3
Figure 3. Chest computed tomography of the patient (case 2) before and after icotinib
(A) tumor mass in left lung on Aug 26th, 2014 (before icotinib): (B) tumor mass in the left lung on Oct 13th, 2014 (one and a half month after icotinib).
Figure 4
Figure 4. Magnetic resonance imaging of brain showed the mass located in the frontal lobe for Case 2
(A) Aug 27, 2014: at initial diagnosis; (B) Oct 16, 2014: after the first surgery; and (C) Feb 3, 2015 at the time of postoperative recurrence.
Figure 5
Figure 5. Kaplan-Meier curve of overall survival in patients with GCCL and with non-GCC NSCLCs (P <0.001)
GCCL: giant cell carcinoma of lung; NSCLC: non-small cell lung cancer
See this image and copyright information in PMC

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