Postoperative survival of EGFR-TKI-targeted therapy in non-small cell lung cancer patients with EGFR 19 or 21 mutations: a retrospective study.
Postoperative survival of EGFR-TKI-targeted therapy in non-small cell lung cancer patients with EGFR 19 or 21 mutations: a retrospective study.
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DOI：
10.1186/s12957-017-1251-z
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发表时间：
2017-11-06
影响因子：
3.2
通讯作者：
He J
中科院分区：
文献类型：
--
作者：
Yang W;Gao Y;Li X;Zhang J;Liu T;Feng X;Pan H;Yang X;Xie S;Feng X;Lv Z;Wang Y;Chen Z;He J
本回顾性研究的目的是确定非小细胞肺癌患者中的表皮生长因子受体（EGFR）突变，并比较不同EGFR突变组之间不同EGFR-TKI靶向治疗效果的长期术后结局。收集2003年1月至2014年1月中国医学科学院肿瘤医院病理科2094例术后EGFR基因检测的非小细胞肺癌（NSCLC）患者。363例患者术后接受EGFR酪氨酸激酶抑制剂（TKI）治疗：184例携带外显子19缺失突变，179例携带外显子21 L 858 R点突变。终点包括无进展生存期（PFS）、总生存期（OS）和缓解率。EGFR 19号外显子缺失组的OS较21号外显子L 858 R点突变组延长（92个月vs. 65个月; P < 0.001）。但两组之间的中位PFS没有差异（12 vs 14个月）。19缺失组的客观缓解率（ORR）高于L 858 R突变组（28.35% vs. 22.73%）。靶向治疗后19缺失组的疾病控制率（DCR）高于L 858 R组（93.71vs.84.31%，P = 0. 014）。在19个缺失组中，埃克替尼治疗患者的ORR和DCR较高，18例患者中有16例达到疾病稳定（SD），该人群的DCR为100%。EGFR亚型可能影响TKI靶向治疗NSCLC患者的术后生存。
The aim of this retrospective study is to identify epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer patients and to compare the long-term postoperative outcomes in different EGFR-TKI-targeted therapy effects between the different EGFR mutation groups. A total of 2094 postoperative non-small cell lung cancer (NSCLC) patients with EGFR gene detection were collected in the Department of Pathology in the Cancer Hospital Chinese Academy of Medical Sciences from January 2003 to January 2014. Three hundred sixty-three patients were treated with EGFR tyrosine kinase inhibitor (TKI) after surgery: 184 harbored the exon 19 deletion mutation and 179 cases carried the exon 21 L858R point mutation. The end points included progression-free survival (PFS), overall survival (OS), and the response rate. OS was increased in the EGFR exon 19 deletion group compared with the exon 21 L858R point mutation group (92 vs. 65 months; P < 0.001). But the median PFS did not differ between two groups (12 vs 14 months). The objective response rate (ORR) in 19 deletion group was increased compared with L858R mutation patients (28.35 vs. 22.73%). The disease control rate (DCR) of patients with 19 deletion benefited more from targeted therapy, compared with L858R group (93.71 vs. 84.31%, P = 0.014). In 19 deletion group, a high ORR and DCR were noted in patients treated with icotinib, 16 out of 18 achieved stable disease (SD), and the DCR in this population was 100%. EGFR subtypes could influence the postoperative survival of NSCLC patients with TKI-targeted therapy.
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