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作者

Chunsheng Wang Kewei Zhao Shanliang Hu Wei Dong Yan Gong Minghuan Li Conghua Xie

作者单位

Tumor Precision Diagnosis and Treatment Technology and Translational Medicine, Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China. ⁵ Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China. Electronic address: chxie_65@whu.edu.cn. Affiliations ¹ Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China. ² Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. ³ Department of Radiation Oncology, Yantai Yuhuangding Hospital, Yantai, China. ⁴ Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, China Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China. Electronic address: sd_lmh@sina.com. ⁶ Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China

刊名

Lung cancer (Amsterdam, Netherlands)

年份

2022

卷号

Vol.172

页码

86-93

ISSN

1872-8332

关键词

EGFR Erlotinib Gefitinib NSCLC Uncommon mutation.

摘要

Background: The purpose of this study was to investigate the outcomes of gefitinib and erlotinib in patients with non-small cell lung cancer with uncommon epidermal growth factor receptor mutations. Methods: Relevant researches were identified by a literature search of the PubMed database. Patients with EGFR mutations other than exon 19 deletion and L858R were eligible for the study. Clinical outcomes included objective response rate , progression free survival , and overall survival . We cate...更多

Background: The purpose of this study was to investigate the outcomes of gefitinib and erlotinib in patients with non-small cell lung cancer with uncommon epidermal growth factor receptor mutations. Methods: Relevant researches were identified by a literature search of the PubMed database. Patients with EGFR mutations other than exon 19 deletion and L858R were eligible for the study. Clinical outcomes included objective response rate , progression free survival , and overall survival . We categorized all uncommon EGFR mutations as: single uncommon EGFR mutations and compound mutations that containing 2 or more kinds of EGFR mutations. We also assessed outcomes in patients categorized by EGFR-TKIs: gefitinib group; erlotinib group. Results: A total of 438 patients with NSCLC harboring uncommon EGFR mutations were included in this study. The ORR for gefitinib and erlotinib was 43.8 %, with a median PFS of 6.00 months and a median OS of 20.50 months. Patients with compound mutations had an ORR of 56.3 % and an mPFS of 8.10 months. Both of them were significantly better than these in patients with single uncommon EGFR mutation, which were 29.3 % and 3.90 months, respectively : 2.74, 95 % confidence interval : 1.86-4.05, P < 0.001; hazard ratio : 0.58, 95 % CI: 0.48-0.71, P < 0.001). Moreover, patients with compound mutations containing 19 deletion or L858R had a superior response and survival benefits compared to patients with other compound mutation patterns. In addition, the gefitinib group showed a favorable efficacy advantage and PFS benefit compared to the erlotinib group. Conclusions: Uncommon EGFR mutations exhibit favorable but inconsistent treatment responses and survival outcomes to gefitinib and erlotinib, which are closely related to the mutation pattern, the cooccurring partner mutant genes, and the type of EGFR-TKIs received.收起

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