Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence
Mutations of the epidermal growth factor receptor gene predict prolonged survival after gefitinib treatment in patients with non-small-cell lung cancer with postoperative recurrence
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DOI：
10.1200/jco.2005.00.992
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发表时间：
2005-04-10
影响因子：
45.3
通讯作者：
Yatabe, Y
中科院分区：
文献类型：
--
作者：
Mitsudomi, T;Kosaka, T;Yatabe, Y
PurposeTo评估表皮生长因子受体（EGFR）基因突变与吉非替尼治疗复发性肺癌患者肺切除术后的疗效之间的关系。Patients and MethodsWe测序EGFR基因外显子18-21的总RNA提取自59例肺癌患者谁与吉非替尼治疗复发性肺癌。吉非替尼的有效性进行了评估，通过影像学研究和血清癌胚抗原（CEA）level.ResultsEGFR突变的变化被发现在33例（56%）。在这些突变中，17个是密码子746-750附近的缺失，15个是点突变（12个在密码子858处，3个在其他密码子处），1个是插入。EGFR突变在女性、腺癌和从不吸烟者中显著更普遍。吉非替尼治疗导致26例患者的肿瘤缩小和/或CEA降低至基线水平的一半以下，24例患者的肿瘤生长和/或CEA升高，9例患者的吉非替尼效应无法评估。从不吸烟的女性腺癌患者对吉非替尼治疗的反应更好。吉非替尼对29例EGFR突变患者中的24例有效，而对21例无突变患者中的2例有效（P
PurposeTo evaluate the relationship between mutations of the epidermal growth factor receptor (EGFR) gene and the effectiveness of gefitinib treatment in patients with recurrent lung cancer after pulmonary resection.Patients and MethodsWe sequenced exons 18-21 of the EGFR gene using total RNA extracted from 59 patients with lung cancer who were treated with gefitinib for recurrent lung cancer. Gefitinib effectiveness was evaluated by both imaging studies and change in serum carcinoembryonic antigen (CEA) levels.ResultsEGFR mutations were found in 33 patients (56%). Of these mutations, 17 were deletions around codons 746-750 and 15 were point mutations (12 at codon 858, three at other codons), and one was an insertion. EGFR mutations were significantly more prevalent in females, adenocarcinoma, and never-smokers. Gefitinib treatment resulted in tumor shrinkage and/or CEA decrease to less than half of the baseline level in 26 patients, tumor growth and/or CEA elevation in 24 patients, and gefitinib effect was not assessable in nine patients. Female, never-smoking patients with adenocarcinoma tended to respond better to gefitinib treatment. Gefitinib was effective in 24 of 29 patients with EGFR mutations, compared with two of 21 patients without mutations (P