Clinicopathologic characteristics and outcomes of Chinese patients with non-small-cell lung cancer and BRAF mutation.
Clinicopathologic characteristics and outcomes of Chinese patients with non-small-cell lung cancer and BRAF mutation.
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中国BRAF突变非小细胞肺癌患者的临床病理特征及结局
DOI：
10.1002/cam4.1014
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发表时间：
2017-03
期刊：
影响因子：
4
通讯作者：
Zhou C
中科院分区：
文献类型：
--
作者：
Ding X;Zhang Z;Jiang T;Li X;Zhao C;Su B;Zhou C
BRAF突变是非小细胞肺癌(NSCLC)的重要致癌基因之一。关于中国BRAF突变型NSCLC患者的数据不充分。因此，我们进行了这项研究，以了解中国人NSCLC和BRAF突变患者的临床病理特征和预后。我们在2012年1月至2016年4月期间发现了BRAF突变的NSCLC患者。分析患者特征和治疗结果。总共纳入了1680名患者。28例(1.7%)患者存在BRAF突变。与非BRAF突变患者相比，BRAF突变患者与腺癌(89.3%比70.6%，P=0.048)和从不吸烟(78.6%比56.7%，P=0.019)有关。两组患者在年龄、性别分布、转移、初诊分期等方面均无显著差异。BRAF突变的患者与一线化疗的EGFR(5.6vs.5.8个月；P=0.277)或KRAS突变(5.6vs.4.7个月；P=0.741)的有效率和无进展生存期(PFS)相似。与非V600E突变的患者相比，V600E突变的肿瘤患者一线化疗的PFS更短，尽管这没有达到统计学意义(5.2vs.6.4个月；P=0.561)。在多变量分析中，只有ECOG PS仍然是总生存率的独立预测因素(HR=0.208；P=0.004)。结论：在中国非小细胞肺癌患者中，BRAF基因突变是罕见的。BRAF突变更有可能与腺癌有关，而从不吸烟。BRAF基因突变与化疗敏感性增强无关，迫切需要抑制BRAF途径的新的有效药物。
BRAF mutation is one of the important driver oncogene in non‐small‐cell lung cancer (NSCLC). Data on Chinese patients with BRAF‐mutant NSCLC are inadequate. Hence, we conducted this study to investigate the clinicopathologic features and outcomes of Chinese patients with NSCLC and BRAF mutations. We identified patients with BRAF‐mutant NSCLC between January 2012 and April 2016. Patient characteristics and treatment outcomes were analyzed. In total, 1680 patients were included. Twenty‐eight (1.7%) patients harbored BRAF mutations. Compared to patients with non‐BRAF mutation, patients with BRAF mutations were associated with adenocarcinomas (89.3% vs. 70.6%, P = 0.048) and never smokers (78.6% vs. 56.7%, P = 0.019). There were no significant differences in the age, gender distribution, metastasis, or stage at first diagnosis between two groups. Response rates and progression‐free survival (PFS) were similar between patient with BRAF mutations and EGFR (5.6 vs. 5.8 months; P = 0.277) or KRAS (5.6 vs. 4.7 months; P = 0.741) mutations to first‐line chemotherapy. Compared to patients with non‐V600E mutations, patients with V600E‐mutated tumors had a shorter PFS to first‐line chemotherapy, although this did not reach statistical significance (5.2 vs. 6.4 months; P = 0.561). In multivariate analyses, only ECOG PS remained the independent predictor of overall survival (HR = 0.208; P = 0.004). In conclusion, BRAF mutation in Chinese patients with NSCLC was rare. BRAF mutation is more likely to be associated with adenocarcinoma and never smokers. BRAF mutations are not associated with enhanced chemosensitivity and novel and effective drugs inhibiting the BRAF pathway are in urgent need.