Medical College, 38043Yangzhou University, Yangzhou, Jiangsu, China.
Institute of Oncology, 370089Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China.
Technol Cancer Res Treat. 2022 Jan-Dec;21:15330338221138213. doi: 10.1177/15330338221138213.
The purpose of this study was to investigate the effect of and comutations on the clinical efficacy of EGFR tyrosine kinase inhibitors (TKIs) in Chinese patients with advanced EGFR-positive nonsmall-cell lung cancer (NSCLC). Tissue samples and information from 65 patients with advanced NSCLC in Northern Jiangsu People's Hospital were collected and analyzed by next-generation sequencing (NGS). Progression-free survival (PFS) and total survival (OS) were the main endpoints, and the objective response rate (ORR) and disease control rate (DCR) were the secondary endpoints. : Among 65 patients, 17 had and wild-type mutations (), 36 had mutant and wild-type mutations (), and 12 had coexisting mutations (). When 12 patients with comutation were compared with the other two groups (, ), mPFS and mOS are significantly lower than those in the other two groups (mPFS: 4.1 months vs 6.0 months, 12.3 months, HR: 0.769, 95% CI: 4.592-7.608, = .047. mOS: 14.6 months vs 24.1 months, 31.5 months, HR: 3.170, 95% CI: 18.786-31.214, < .001), and the ORR, DCR of patients with comutation was lower than that of the other two groups (ORR, 25% vs 44.4%, 70.6%, = .045. DCR, 58.3% vs 72.2%, 82.4%, = .365). Patients with comutations with EGFR-positive advanced NSCLC are more likely to develop drug resistance after early treatment with EGFR-TKIs and have a worse clinical outcome.
本研究旨在探讨 及 共突变对中国晚期 EGFR 阳性非小细胞肺癌（NSCLC）患者接受表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗临床疗效的影响。通过下一代测序（NGS），收集并分析了来自苏北人民医院的 65 例晚期 NSCLC 患者的组织样本和信息。无进展生存期（PFS）和总生存期（OS）是主要终点，客观缓解率（ORR）和疾病控制率（DCR）是次要终点。结果：在 65 例患者中，17 例存在 和 野生型突变（），36 例存在 突变和 野生型突变（），12 例存在 共突变（）。与另外两组（，）相比，当比较 12 例 共突变患者时，mPFS 和 mOS 明显低于另外两组（mPFS：4.1 个月比 6.0 个月和 12.3 个月，HR：0.769，95%CI：4.592-7.608，=0.047。mOS：14.6 个月比 24.1 个月和 31.5 个月，HR：3.170，95%CI：18.786-31.214，<0.001），且 共突变患者的 ORR 和 DCR 均低于另外两组（ORR，25%比 44.4%和 70.6%，=0.045。DCR，58.3%比 72.2%和 82.4%，=0.365）。患有 及 共突变的 EGFR 阳性晚期 NSCLC 患者在接受 EGFR-TKIs 早期治疗后更容易发生耐药，临床结局更差。
