Zeng Linmiao, Dai Yiqun, Liu Yuting, Song Bin, Lin Hui, Xiao Jianhong
Department of Respiratory Medicine, Mindong Hospital Affiliated to Fujian Medical University, Fu'an City, China.
Fujian Medical University, Fuzhou City, Shangjie Town, Minhou County, Fuzhou, China.
Oncol Res Treat. 2024;47(12):602-609. doi: 10.1159/000541520. Epub 2024 Oct 1.
Lung cancer is a major contributor to cancer-related death worldwide. Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are currently viewed as the established first-line therapy for patients with advanced NSCLC with EGFR mutations.
The potential predictive value of the quantitative abundance of epidermal growth factor receptor (EGFR) mutations in the treatment of NSCLC is widely recognized and regarded as a significant indicator. The definition of mutation abundance in the EGFR gene in most current studies is mainly calculated based on the ratio of mutation to wild-type gene copy number or based on the ratio of allele number; for example, variant allele frequency is the ratio of the number of mutant alleles to the total number of alleles at a particular locus. Results of the included primary studies are as follows. (1) Significant association between EGFR mutation abundance and progression-free survival (PFS): median PFS was significantly longer in the high abundance group (11.0 months, 95% CI: 9.7-12.3 months) than in the low abundance group (5.3 months, 95% CI: 3.6-7.0 months) in the study by Liu et al. High mutation abundance (HR: 0.77, 95% CI: 0.66-0.82, p = 0.037) was an independent prognostic determinant of PFS in the study by Wang et al. Among patients receiving EGFR-TKI as first-line therapy, the median PFS was significantly longer in the high mutation abundance group than in the low mutation abundance group (12.7 months vs. 8.7 months, p = 0.002). EGFR mutation abundance ≥30% was an independent risk factor for PFS (HR: 1.64, 95% CI: 1.17-2.31). (2) Significant association between EGFR mutation abundance and overall survival (OS): the median OS in the high abundance group in the study by Liu et al. was 20.9 months (95% CI: 18.3-23.5 months), while that in the low abundance group was 13.0 months (95% CI: 10.0 months) (95% CI: 10.3-15.7 months); longer OS was independently associated with high mutation abundance (HR: 0.62, 95% CI: 0.50-0.79, p = 0.027).
The objective of this article was to conduct a comprehensive examination and analysis of the association between the abundance of EGFR mutations in NSCLC and the effectiveness of treatment with TKIs while also considering the development of drug resistance.
肺癌是全球癌症相关死亡的主要原因。非小细胞肺癌（NSCLC）约占所有肺癌的85%。表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）目前被视为晚期NSCLC伴EGFR突变患者既定的一线治疗方法。
表皮生长因子受体（EGFR）突变定量丰度在NSCLC治疗中的潜在预测价值已得到广泛认可，并被视为一个重要指标。目前大多数研究中EGFR基因中突变丰度的定义主要基于突变与野生型基因拷贝数的比例或基于等位基因数的比例来计算；例如，变异等位基因频率是特定位点突变等位基因数与总等位基因数的比例。纳入的主要研究结果如下。（1）EGFR突变丰度与无进展生存期（PFS）之间存在显著关联：Liu等人的研究中，高丰度组的中位PFS（11.0个月，95%CI：9.7-12.3个月）显著长于低丰度组（5.3个月，95%CI：3.6-7.0个月）。Wang等人的研究中，高突变丰度（HR：0.77，95%CI：0.66-0.82，p = 0.037）是PFS的独立预后决定因素。在接受EGFR-TKI作为一线治疗的患者中，高突变丰度组的中位PFS显著长于低突变丰度组（12.7个月对8.7个月，p = 0.002）。EGFR突变丰度≥30%是PFS的独立危险因素（HR：1.64，95%CI：1.17-2.31）。（2）EGFR突变丰度与总生存期（OS）之间存在显著关联：Liu等人的研究中，高丰度组的中位OS为20.9个月（95%CI：18.3-23.5个月），而低丰度组为13.0个月（95%CI：10.0-15.7个月）；较长的OS与高突变丰度独立相关（HR：0.62，95%CI：0.50-0.79，p = 0.027）。
本文的目的是对NSCLC中EGFR突变丰度与TKIs治疗有效性之间的关联进行全面检查和分析，同时考虑耐药性的发展。
