PURPOSE
The spectrum of
EGFR
is inadequately researched in patients with early-stage non–small cell lung cancer (NSCLC) in India. EARLY-epidermal growth factor receptor (EGFR) India (ClinicalTrials.gov identifier:
NCT04742192
), as part of a noninterventional, real-world global study, evaluated the prevalence of
EGFR
mutations in early-stage NSCLC in India.
METHODS
Prospective data from adult patients with surgically resected stage IA to IIIB (American Joint Committee on Cancer eighth edition) NSCLC between March 2021 and October 2022 were analyzed. In addition to descriptive statistics, Fisher's exact test with Monte Carlo was used to determine the association between
EGFR
mutations and clinicodemographic parameters.
RESULTS
Of 74 patients (median age, 57.0 [range, 33.0-77.0] years) enrolled from eight centers in India, 73.0% (54 of 74) were males, 56.1% (37 of 66) were nonsmokers, and 95.9% (71 of 74) had adenocarcinoma. The
EGFR
mutation prevalence was 26.0% (19 of 73), of which
Exon-19
deletions were the predominant subtype (13, 68.4%) followed by
Exon 21-L858R
(4, 21.1%),
Exon 20-T790M
(1, 5.3%), and compound (1, 5.3%) mutations. Nearly half (48.6%, 36 of 74) of the patients underwent only surgical resection. The remaining 51.4% (38 of 74) of the patients were prescribed neoadjuvant (n = 12; 16.2%) and adjuvant (n = 31; 41.9%) systemic therapies, and one patient (1.4%) received radiotherapy along with systemic therapy. In 60 patients with stage IB to IIIB NSCLC, systemic therapies, mainly platinum-based chemotherapy, were prescribed in 36 (60.0%). Only 8.1% (6 of 74) of the patients were prescribed EGFR-tyrosine kinase inhibitor (TKI), of which two received neoadjuvant and four were planned for adjuvant EGFR-TKI. Two (2.7%) patients were prescribed adjuvant immunotherapy. The univariate analysis showed higher odds of
EGFR
mutation for females (odds ratio, 3.96;
P
= .017).
CONCLUSION
EARLY-EGFR India results showed the prevalence of
EGFR
mutation to be 26%. The study emphasized the pressing need for up-front biomarker testing at diagnosis to ensure optimal and timely personalized treatment.