ORIGINAL RESEARCH EGFR activating mutations and their association with response to platinum-doublet chemotherapy in Brazilian non-small cell lung cancer patients Helen N. Honma & Maurício W. Perroud Jr. & Maurício S. T. Leme & Aristóteles S. Barbeiro & Bruna A. Saad & André M. Morcillo & José Vassallo & Daniel B. Costa & Lair Zambon Received: 12 November 2013 /Accepted: 3 April 2014 # Springer International Publishing Switzerland 2014 Abstract The aim of the study was to analyze the frequency of epidermal growth factor receptor (EGFR) mutations in Brazilian non-small cell lung cancer patients and to correlate these mutations with response to benefit of platinum-based chemotherapy in non-small cell lung cancer (NSCLC). Our cohort consisted of prospective patients with NSCLCs who received chemotherapy (platinum derivates plus paclitaxel) at the [UNICAMP], Brazil. EGFR exons 18–21 were analyzed in tumor-derived DNA. Fifty patients were included in the study (25 with adenocarcinoma). EGFR mutations were identified in 6/50 (12 %) NSCLCs and in 6/25 (24 %) adenocarcinomas; representing the frequency of EGFR mutations in a mostly self-reported White (82.0 %) southeastern Brazilian popula- tion of NSCLCs. Patients with NSCLCs harboring EGFR exon 19 deletions or the exon 21 L858R mutation were found to have a higher chance of response to platinum-paclitaxel (OR 9.67 [95 % CI 1.03–90.41], p =0.047). We report the frequency of EGFR activating mutations in a typical south- eastern Brazilian population with NSCLC, which are similar to that of other countries with Western European ethnicity. EGFR mutations seem to be predictive of a response to platinum-paclitaxel, and additional studies are needed to con- firm or refute this relationship. Keywords Non-small cell lung cancer . EGFR mutations . Tyrosine kinase inhibitor Introduction Lung cancer is the leading cause of morbidity and mortality related to cancer worldwide, with over 1.6 million new cases and 1.4 million deaths per year [1]. These numbers correspond to 28 and 26 % of all cancer deaths among men and women, respectively [2]. For patients who present with advanced non- small-cell lung cancer (NSCLC), systemic chemotherapy is the primary treatment modality [3]. In this setting, platinum- based doublet chemotherapies (carboplatin or cisplatin plus another cytotoxic agent, such as paclitaxel, docetaxel, gemcitabine, vinorelbine, or pemetrexed) are generally rec- ommended for patients with adequate performance status [4]. Despite the known variability in the effectiveness of chemo- therapy, few predictive biomarkers exist; despite ongoing attempts to use tumor and patient-derived genomic and/or proteomic markers to maximize efficacy and minimize toxic- ity [5–9]. Over the last decade, the advancement of biomarker-driven personalized therapies has changed the management of many cancers, including NSCLC. Precision therapies developed H. N. Honma : M. W. Perroud Jr. : M. S. T. Leme : A. S. Barbeiro : L. Zambon (*) Department of Internal Medicine, School of Medical Sciences, University of Campinas (Unicamp), Rua Tessália Vieira de Camargo nº 126, Cidade Universitária Zeferino Vaz, Distrito de Barão Geraldo, Campinas, SP, Brazil e-mail: lzambon@fcm.unicamp.br A. M. Morcillo Department of Pediatrics, University of Campinas (Unicamp), Campinas, SP, Brazil J. Vassallo Department of Anatomical Pathology; School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP, Brazil D. B. Costa Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA B. A. Saad School of Medicine, Centro Universitário Lusíada, São Paulo, Brazil Targ Oncol DOI 10.1007/s11523-014-0314-0