Liu Yongmei, Zhang Yan, Zhang Li, Liu Bin, Wang Yongsheng, Zhou Xiaojuan, Li Yanying, Zhao Qian, Gong Youling, Zhou Lin, Zhu Jiang, Ding Zhenyu, Wang Jin, Peng Feng, Huang Meijuan, Li Lu, Ren Li, Lu You
Department of Thoracic Oncology, Cancer Center and State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.
Oncotarget. 2017 Jul 25;8(30):49680-49688. doi: 10.18632/oncotarget.17915.
Epidermal growth factor receptor (EGFR) mutations are common in lung adenocarcinoma (ADC) but rare in squamous cell carcinoma (SQC). The efficacy of EGFR-tyrosine kinase inhibitors (EGFR-TKIs) for SQC with EGFR mutations is unclear. The aim of this study was to evaluate the efficacy of EGFR-TKIs for these patients. We performed a retrospective matched-pair case-control study from 3 cancer centers, including 44 SQC and 44 ADC patients with EGFR mutation who were treated with EGFR-TKI. Subsequently, we performed a pooled analysis on the efficacy of EGFR-TKIs for EGFR-mutant SQC in 115 patients, including 71 patients selected from 25 published reports. In our multicenter study, EGFR-mutant SQC and ADC patients had similar objective response rate (ORR) (43.2% vs. 54.5%, p = 0.290), but SQC patients had lower disease control rate (DCR) (71.3% vs. 100%, p = 0.001), significant shorter median progression free survival (PFS) (5.1 vs. 13.0 months, p = 0.000) and median overall survival (OS) (17.2 vs. 23.6 months, p = 0.027). In pooled analysis, the ORR, DCR, PFS and OS of SQC patients were 39.1%, 71.3%, 5.6 months and 15.0 months, respectively. Performance status was the only independent predictor of PFS and erlotinib treatment was associated with a better survival. In conclusion, EGFR-TKI was less effective in EGFR-mutant SQC than in ADC but still has clinical benefit for SQC patients. Further study is need to evaluate the using of EGFR-TKIs in these SQC patients.
表皮生长因子受体(EGFR)突变在肺腺癌(ADC)中很常见,但在肺鳞状细胞癌(SQC)中很少见。EGFR酪氨酸激酶抑制剂(EGFR-TKIs)对伴有EGFR突变的SQC的疗效尚不清楚。本研究的目的是评估EGFR-TKIs对这些患者的疗效。我们在3个癌症中心进行了一项回顾性配对病例对照研究,纳入了44例接受EGFR-TKI治疗的伴有EGFR突变的SQC患者和44例伴有EGFR突变的ADC患者。随后,我们对115例EGFR突变的SQC患者中EGFR-TKIs的疗效进行了汇总分析,其中71例患者选自25篇已发表的报告。在我们的多中心研究中,EGFR突变的SQC患者和ADC患者的客观缓解率(ORR)相似(43.2%对54.5%,p = 0.290),但SQC患者的疾病控制率(DCR)较低(71.3%对100%,p = 0.001),无进展生存期(PFS)中位数显著缩短(5.1个月对13.0个月,p = 0.000),总生存期(OS)中位数也显著缩短(17.2个月对23.6个月,p = 0.027)。在汇总分析中,SQC患者的ORR、DCR、PFS和OS分别为39.1%、71.3%、5.6个月和15.0个月。体能状态是PFS的唯一独立预测因素,厄洛替尼治疗与更好的生存相关。总之,EGFR-TKI在EGFR突变的SQC中比在ADC中效果更差,但对SQC患者仍有临床益处。需要进一步研究评估EGFR-TKIs在这些SQC患者中的应用。