Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine Guangzhou 510060, China;
J Thorac Dis. 2013 Oct;5(5):585-92. doi: 10.3978/j.issn.2072-1439.2013.09.15.
Epidermal growth factor receptor (EGFR) mutation mostly occurred in lung adenocarcinoma, rarely in squamous cell carcinoma (SQCC). EGFR mutation rate in SQCC varied in previous reports, and the efficacy of EGFR tyrosine kinase inhibitors (TKIs) in SQCC harboring EGFR mutation has not yet been fully evaluated. The aim of this study was to investigate the efficacy EGFR-TKIs for Chinese patients with SQCC of lung harboring EGFR mutation.
Two cohorts of patients were analyzed. The first cohort included 146 consecutive post-operation SQCC patients from January 2008 to October 2012. The second cohort included 63 patients with advanced SQCC receiving EGFR-TKIs treatment. EGFR mutation analysis was performed with Real-time PCR method. The pathologic diagnosis was validated with immunohistochemistry (IHC) for patients harboring activated EGFR mutation. And the efficacy of EGFR-TKIs in squamous cell carcinoma of lung (SQCC) was evaluated in patients with activated EGFR mutations.
In the first cohort, 146 resected patients, EGFR mutations were detected in 3 patients, with the mutation rate of 2.0%. In cohort two, 63 patients treated with EGFR-TKIs, 15 patients possessed activated EGFR mutations. The response rate and disease control rate in these patients was 26.7% and 66.7% respectively. 5 patients had disease control over 6 months. The progression free survival (PFS) in EGFR-mutated patients was 3.9 months.
In Chinese SQCC patients, EGFR mutation rate was extremely low. EGFR-TKIs seemed to be less effective in EGFR-mutated SQCC patients, but some patients could still obtain benefit from EGFR-TKIs. To identify this part of patients, further study was warranted in the future.
表皮生长因子受体（EGFR）突变主要发生在肺腺癌中，很少发生在鳞状细胞癌（SQCC）中。之前的报道显示，SQCC 中的 EGFR 突变率存在差异，并且 EGFR 酪氨酸激酶抑制剂（TKI）在携带 EGFR 突变的 SQCC 中的疗效尚未得到充分评估。本研究旨在探讨 EGFR-TKI 在中国 EGFR 突变型肺鳞癌患者中的疗效。
分析了两个队列的患者。第一队列包括 2008 年 1 月至 2012 年 10 月期间连续 146 例手术后 SQCC 患者。第二队列包括 63 例接受 EGFR-TKI 治疗的晚期 SQCC 患者。采用实时 PCR 法进行 EGFR 突变分析。对于携带激活 EGFR 突变的患者，采用免疫组织化学（IHC）验证病理诊断。并评估激活 EGFR 突变的患者中 EGFR-TKI 对肺鳞癌（SQCC）的疗效。
在第一队列中，在 146 例切除的患者中，检测到 3 例存在 EGFR 突变，突变率为 2.0%。在第二队列中，63 例接受 EGFR-TKI 治疗的患者中，有 15 例存在激活的 EGFR 突变。这些患者的缓解率和疾病控制率分别为 26.7%和 66.7%。5 例患者疾病控制时间超过 6 个月。EGFR 突变患者的无进展生存期（PFS）为 3.9 个月。
在中国 SQCC 患者中，EGFR 突变率极低。EGFR-TKI 似乎对 EGFR 突变型 SQCC 患者疗效不佳，但部分患者仍可从 EGFR-TKI 中获益。为了识别这部分患者，未来需要进一步研究。
