Only one patient carried the same KRAS mutation in both primary

tumor and metastatic tumor (Table 2, case 31). Six samples had PX-478 datasheet mutations in lymph node metastases but not in their corresponding primary GSK3326595 purchase tumor tissues (Table 2, case7 to case12). Two of the KRAS mutation-positive samples (Table 2, case 7 and case 8) also carried the L858R EGFR mutation. NSCLC samples harboring both KRAS and EGFR mutations have rarely been reported previously. One sample had a KRAS mutation only in the metastases; the other one had KRAS mutations in both sites. The correlation between KRAS mutation and clinical parameters such as gender, smoke history and pathologic type was not statistically significant. Discordance in KRAS mutation status between primary

tumors and lymph node metastases observed in six patients was found statistically significant (McNemar’s test, P = 0.0412, Table 3). The majority (6/7) of all cases with KRAS mutations were squamous cell lung cancers. The other one was an adenocarcinoma. Table 2 Comparison of EGFR and KRAS status between primary and metastatic tumors in VX-809 price NSCLC patients Case No. EGFR mutation status KRAS mutation status   primary metastasis primary metastasis 1 E746-A750 L747-T751 wt wt 2 L747-P753insS R748-P752 wt wt 3 wt L747-P753 wt wt 4 wt L858R wt wt 5 wt L858R wt wt 6 wt L858R wt wt 7 wt L858R wt G12V 8 L858R L858R wt G12A 9 wt wt wt G12V 10 wt wt wt G13D 11 wt wt wt G12S 12 wt wt wt G13D 13 E746-A750 E746-A750 wt wt 14 E746-A750 E746-A750 wt wt 15 E746-A750 E746-A750 wt wt 16 E746-A750 E746-A750 wt wt

17 E746-A750 E746-A750 5-Fluoracil in vivo wt wt 18 E746-A750 E746-A750 wt wt 19 E746-A750 E746-A750 wt wt 20 L858R L858R wt wt 21 L858R L858R wt wt 22 L858R L858R wt wt 23 L858R L858R wt wt 24 L858R L858R wt wt 25 L858R L858R wt wt 26 L858R L858R wt wt 27 L747-S752,P753E L747-S752,P753E wt wt 28 E746-T751insV/A E746-T751insV/A wt wt 29 E747-S752insV E747-S752insV wt wt 30 I740-K745 I740-K745 wt wt 31 wt wt G12A G12A 32 wt wt wt wt .   .   .   80 wt wt wt wt Table 3 Combined analysis of EGFR and KRAS status in NSCLC patients Primary/Metastatic tumor   WT/WT WT/MUT MUT/WT MUT/MUT Discordance EGFR 54 5 0 21* 7 case KRAS 73 6 0 1 6 case * E746-A750/L747-T751; L747-P753insS/R748-P752 Abbreviation: WT, wild type; MUT, mutational type EGFR gene mutations in NSCLC primary tumors and corresponding local lymph node metastases EGFR mutations were detected in twenty-one primary tumors and twenty-six lymph node metastases. The types and locations of the mutations in paired tumors were shown in Table 2. Thirteen cases of the in-frame deletions in exon 19 and eight cases of point mutation in exon 21 were found in the primary tumors. Twenty-six cases with EGFR mutations in the lymph nodes included fourteen cases of the in-frame deletions in exon 19 and twelve cases of the point mutation in exon 21.