Pham Van Luan, Pham Cam Phuong, Nguyen Thi Thai Hoa, Nguyen Tuan Khoi, Nguyen Minh Hai, Hoang Thi Anh Thu, Le Tuan Anh, Vuong Dinh Thy Hao, Nguyen Dac Nhan Tam, Dang Van Khiem, Nguyen Thi Oanh, Do Hung Kien, Vu Ha Thanh, Nguyen Thi Thuy Hang, Pham Van Thai, Trinh Le Huy, Nguyen Hoang Gia, Truong Cong Minh, Pham Tran Minh Chau, Nguyen Thi Bich Phuong
Military Central Hospital 108, Hanoi, Vietnam.
College of Health Sciences, VinUniversity, Vietnam.
Ther Adv Respir Dis. 2025 Jan-Dec;19:17534666251341747. doi: 10.1177/17534666251341747. Epub 2025 May 24.
Afatinib is indicated for patients with advanced-stage non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations, including uncommon mutations. However, the differences in survival benefits between patients with different types of EGFR mutations remain unclear.
This study aimed to compare the effectiveness of afatinib treatment in patients harboring the EGFR-G719X mutation with that in patients carrying other uncommon EGFR mutations.
This was a retrospective study.
Ninety-two patients with locally advanced and metastatic NSCLC, of whom 49 patients with EGFR-G719X mutations that were both single and compound, and 43 patients harbored other uncommon EGFR mutations, who were treated with afatinib as first-line treatment. The patients were followed up and evaluated every 3 months or when there were symptoms of progressive disease. The endpoints were the objective response rate (ORR), time-to-treatment failure (TTF), and overall survival (OS).
The average ages of patients with the EGFR-G719X and uncommon EGFR mutations were 62.7 years and 63.1 years, respectively. There were no significant differences in sex or smoking history between the two groups. In total, 28.6% of patients with the G719X mutation and 23.3% of patients with other mutations had brain metastases. The ORR of patients with the G719X mutation was 79.6%, which was 10% higher than that of patients with other EGFR mutations. Patients harboring the EGFR-G719X mutation had median TTF and median OS periods of 19.3 months and 31.4 months, respectively, which were significantly higher than those of patients carrying other mutations at 11.2 months. Subgroup analysis showed that TTF and OS benefits were observed in female patients, patients without brain metastasis, and patients with good performance status who harbored the G719X mutation.
Patients with the EGFR-G719X mutation achieve significantly better TTF and OS benefits than those with other uncommon EGFR mutations.
阿法替尼适用于晚期非小细胞肺癌（NSCLC）且具有表皮生长因子受体（EGFR）突变的患者，包括罕见突变。然而，不同类型EGFR突变患者的生存获益差异仍不明确。
本研究旨在比较阿法替尼治疗携带EGFR-G719X突变患者与携带其他罕见EGFR突变患者的有效性。
这是一项回顾性研究。
92例局部晚期和转移性NSCLC患者，其中49例为单突变和复合突变的EGFR-G719X突变患者，43例携带其他罕见EGFR突变患者，均接受阿法替尼一线治疗。每3个月或出现疾病进展症状时对患者进行随访和评估。终点指标为客观缓解率（ORR）、治疗失败时间（TTF）和总生存期（OS）。
EGFR-G719X突变患者和罕见EGFR突变患者的平均年龄分别为62.7岁和63.1岁。两组患者的性别和吸烟史无显著差异。G719X突变患者中有28.6%发生脑转移，其他突变患者中有23.3%发生脑转移。G719X突变患者的ORR为79.6%，比其他EGFR突变患者高10%。携带EGFR-G719X突变患者的TTF和OS中位数分别为19.3个月和31.4个月，显著高于携带其他突变患者的11.2个月。亚组分析显示，携带G719X突变的女性患者、无脑转移患者和体能状态良好的患者在TTF和OS方面有获益。
与其他罕见EGFR突变患者相比，EGFR-G719X突变患者在TTF和OS方面获益显著更好。
