Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
J Thorac Oncol. 2014 May;9(5):725-8. doi: 10.1097/JTO.0000000000000105.
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors and Met inhibitors have enabled progress in the management of advanced non-small-cell lung cancer (NSCLC). However, the clinical benefits of these agents are not uniform across the NSCLC spectrum. Thus, we evaluated the prognostic effect of mesenchymal-epithelial transition (MET) expression in Asian NSCLC patients with or without EGFR mutation.
Frozen tumor tissues were collected from 92 patients with surgical resection and 10 with lymph node biopsy. Mutations in exons 18-21 in the EGFR-tyrosine kinase domain and MET expression were analyzed by using sequencing and immunohistochemistry, respectively.
The MET overexpression rate was 51% in NSCLC patients. MET-positive patients had poorer overall survival than MET-negative patients (29.8 versus 69.1 months, χ = 7.420, p = 0.006) in patients with wild-type EGFR. However, no statistically significant difference was found in EGFR mutant patients (35.0 versus 35.9 months, χ = 0.114, p = 0.735). Multivariate analysis showed that stage, MET expression, and sex were independent prognostic factors in patients with wild-type EGFR (χ = 32.896, p < 0.001).
These results suggest that MET expression has different prognostic significance in patients with differing EGFR mutation status. Whether MET inhibitors should be given early to NSCLC patients with EGFR wild-type needs further investigation.
表皮生长因子受体(EGFR)酪氨酸激酶抑制剂和 Met 抑制剂使晚期非小细胞肺癌(NSCLC)的治疗取得了进展。然而,这些药物在 NSCLC 患者中的临床获益并不一致。因此,我们评估了 MET 表达在亚洲 NSCLC 患者(有无 EGFR 突变)中的预后作用。
收集了 92 例手术切除和 10 例淋巴结活检的 NSCLC 患者的冷冻肿瘤组织。分别通过测序和免疫组化分析 EGFR 酪氨酸激酶结构域外显子 18-21 中的突变和 MET 表达。
NSCLC 患者的 MET 过表达率为 51%。在 EGFR 野生型患者中,MET 阳性患者的总生存期比 MET 阴性患者差(29.8 与 69.1 个月,χ=7.420,p=0.006)。然而,在 EGFR 突变患者中,差异无统计学意义(35.0 与 35.9 个月,χ=0.114,p=0.735)。多因素分析显示,在 EGFR 野生型患者中,分期、MET 表达和性别是独立的预后因素(χ=32.896,p<0.001)。
这些结果表明,MET 表达在 EGFR 突变状态不同的患者中有不同的预后意义。是否应早期给予 EGFR 野生型 NSCLC 患者 MET 抑制剂,需要进一步研究。