Yang W J, Gao Y B, Qiu T, Wang Y G, He J
Department of Thoracic Surgery, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2017 Oct 23;39(10):732-736. doi: 10.3760/cma.j.issn.0253-3766.2017.10.003.
To investigate the efficacy of tyrosine kinase inhibitor (TKI) treatment on non-small cell lung cancer (NSCLC) patients with postoperative recurrence who harbored uncommon EGFR mutations, and discuss the relationship between TKI treatment and prognosis. A total of 39 relapsed NSCLC patients after surgery with EGFR uncommon mutations who were detected at Cancer Hospital, Chinese Academy of Medical Sciences between January 1999 and December 2013 were retrospectively analyzed in this study. Twenty patients were treated with EGFR-TKI after recurrence and 19 cases were not. The clinical characteristics of patients with EGFR uncommon mutations were evaluated, and the prognosis of TKI-treatment group and non-TKI treatment group was compared. In 39 relapsed NSCLC patients with EGFR uncommon mutations, insertion mutations and point mutations were included. The highest frequency of EGFR uncommon mutation happened in exon 20 (20/39, 51.3%). A total of 13 uncommon point mutations were detected in exon 18, 20 and 21. The most frequent rare point mutations located in exon 21, and there were 7 different point mutation sites in exon 21. G719S/C/A mutation in exon 18 was the most common type of point mutation (14/25, 56.0%). Survival after postoperative recurrence in TKI treatment group was obviously better than that in non-TKI treatment group, the median time after recurrence were 44 months and 23 months, respectively (=0.044). However, the postoperative overall survival showed no differences between two groups (48 months vs 43 months, =0.129). NSCLC patients with postoperative recurrence who harbored rare EGFR mutations should be treated with TKI agent.
探讨酪氨酸激酶抑制剂（TKI）治疗对具有罕见表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）术后复发患者的疗效，并讨论TKI治疗与预后的关系。本研究回顾性分析了1999年1月至2013年12月在中国医学科学院肿瘤医院检测到的39例术后复发且具有EGFR罕见突变的NSCLC患者。20例复发后接受EGFR-TKI治疗，19例未接受治疗。评估了具有EGFR罕见突变患者的临床特征，并比较了TKI治疗组和非TKI治疗组的预后。在39例复发且具有EGFR罕见突变的NSCLC患者中，包括插入突变和点突变。EGFR罕见突变的最高频率发生在外显子20（20/39，51.3%）。在外显子18、20和21中总共检测到13个罕见点突变。最常见的罕见点突变位于外显子21，外显子21中有7个不同的点突变位点。外显子18中的G719S/C/A突变是最常见的点突变类型（14/25，56.0%）。TKI治疗组术后复发后的生存期明显优于非TKI治疗组，复发后的中位时间分别为44个月和23个月（P=0.044）。然而，两组术后总生存期无差异（48个月对43个月，P=0.129）。具有罕见EGFR突变的NSCLC术后复发患者应接受TKI药物治疗。
