Joshi Amit, Zanwar Saurabh, Noronha Vanita, Patil Vijay M, Chougule Anuradha, Kumar Rajiv, Janu Amit, Mahajan Abhishek, Kapoor Akhil, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Hospital.
Molecular Laboratory, Department of Medical Oncology.
Onco Targets Ther. 2017 Mar 28;10:1859-1863. doi: 10.2147/OTT.S125397. eCollection 2017.
EGFR tyrosine kinase inhibitors (TKIs) have greatly improved the outcomes of mutation-positive adenocarcinomas of the lung. In contrast, the significance of mutation in metastatic squamous cell carcinoma (SCC) of the lung has been debated.
All patients with metastatic SCC who underwent mutation testing at our center from 2010 to 2015 were included for analysis. kinase domain mutations were tested using Taqman-based real-time polymerase chain reaction (PCR). Response assessment was done using Response Evaluation Criteria In Solid Tumors (RECIST) 1.1. Kaplan-Meier method was used for calculating progression-free survival (PFS) and overall survival (OS).
mutation was detected in 29 out of 639 patients with SCC. Furthermore, 19 out of the 29 patients received TKIs at some point during their treatment. TKI therapy led to a partial response in 5 out of 19 patients and stable disease in 4 out of 19 patients. The median PFS of patients treated with TKIs was 5.0 months. The median OS of the whole -positive SCC cohort was 6.6 months. On univariate analysis, patients having received TKI therapy was the only factor associated with a significantly better OS of 13.48 months versus 2.58 months (=0.000). On multivariate analysis, patients receiving TKI therapy, Eastern Cooperative Oncology Group-Performance Scale (ECOG-PS) score <2, exon 19 mutation and nonsmoking status were associated with significantly better OS.
mutation in SCC of the lung predicts a better outcome if the patient is given TKI, but it may be inferior to the outcomes seen in -positive adenocarcinomas treated with TKI.
表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKIs）显著改善了EGFR突变阳性肺腺癌的治疗效果。相比之下，EGFR突变在肺转移性鳞状细胞癌（SCC）中的意义一直存在争议。
纳入2010年至2015年在本中心接受EGFR突变检测的所有转移性SCC患者进行分析。使用基于Taqman的实时聚合酶链反应（PCR）检测激酶结构域突变。采用实体瘤疗效评价标准（RECIST）1.1进行疗效评估。采用Kaplan-Meier法计算无进展生存期（PFS）和总生存期（OS）。
639例SCC患者中，29例检测到EGFR突变。此外，29例患者中有19例在治疗期间的某个时间点接受了TKIs治疗。TKIs治疗使19例患者中的5例出现部分缓解，19例患者中的4例病情稳定。接受TKIs治疗患者的中位PFS为5.0个月。整个EGFR阳性SCC队列的中位OS为6.6个月。单因素分析显示，接受TKIs治疗的患者是唯一与OS显著改善相关的因素，OS为13.48个月，而未接受治疗的患者为2.58个月（P=0.000）。多因素分析显示，接受TKIs治疗、东部肿瘤协作组体能状态（ECOG-PS）评分<2、外显子19突变和非吸烟状态与OS显著改善相关。
肺SCC中的EGFR突变如果患者接受TKIs治疗则预示着更好的预后，但可能不如EGFR阳性腺癌接受TKIs治疗的效果。
