https://scholars.lib.ntu.edu.tw/handle/123456789/494418
標題: | Complex EGFR mutations with secondary T790M mutation confer shorter osimertinib progression-free survival and overall survival in advanced non-small cell lung cancer | 作者: | YEN-TING LIN TZU-HSIU TSAI SHANG-GIN WU Liu Y.-N. CHONG-JEN YU JIN-YUAN SHIH |
公開日期: | 2020 | 出版社: | Elsevier Ireland Ltd | 卷: | 145 | 起(迄)頁: | 1-9 | 來源出版物: | Lung Cancer | 摘要: | Objectives: Osimertinib is active against epidermal growth factor receptor (EGFR) T790M-mutated non-small cell lung cancer (NSCLC). However, its efficacy against complex EGFR mutations with T790M has not been evaluated. Materials and methods: In order to detect complex EGFR mutations, we consecutively sequenced cancer tissues by RNA reverse transcription polymerase chain reaction. Patients with advanced NSCLC with activating EGFR mutation and secondary T790M who received osimertinib were enrolled. Patients’ clinicopathologic characteristics, prior treatment details, and osimertinib treatment outcomes were analyzed. Results: Totally, 165 sequenced patients were analyzed. Eleven (7%) of them had complex EGFR mutations with T790M. The osimertinib response rate was 27%. They had a shorter progression-free survival (PFS) (median, 2.9 and 9.7 months, p < 0.001) and overall survival (OS) (median, 17.8 and 31.0 months, p = 0.01) than patients with a single EGFR mutation with T790M. After osimertinib failure, seven patients received rebiopsy with molecular analysis. Four lost the T790M, two transformed to small cell and one acquired C797S. Moreover, taking the median as the demarcation, patients received shorter prior EGFR tyrosine kinase inhibitor (TKI) treatment duration had a shorter osimertinib PFS (median, 7.3 and 13.8 months, p < 0.001) and OS (median, 21.5 and 36.7 months, p = 0.003). Multivariate Cox regression analysis confirmed complex EGFR mutations and prior EGFR TKI treatment duration were independent factors for osimertinib PFS and OS. Conclusions: Complex EGFR mutations and shorter prior EGFR TKI treatment duration may confer shorter osimertinib PFS and OS in advanced NSCLC with secondary T790M mutation. ? 2020 Elsevier B.V. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85084234038&doi=10.1016%2fj.lungcan.2020.04.022&partnerID=40&md5=f6c42d40cbe384d019d5fd7c529ab687 https://scholars.lib.ntu.edu.tw/handle/123456789/494418 |
ISSN: | 0169-5002 | DOI: | 10.1016/j.lungcan.2020.04.022 | SDG/關鍵字: | afatinib; epidermal growth factor receptor; erlotinib; gefitinib; nazartinib; olmutinib; osimertinib; rociletinib; zorifertinib; adult; aged; Article; cancer tissue; cohort analysis; drug response; EGFR gene; female; gene activation; gene mutation; human; human cell; human tissue; lung biopsy; major clinical study; male; non small cell lung cancer; overall survival; pathology; priority journal; progression free survival; reverse transcription polymerase chain reaction; RNA sequence; treatment duration; treatment failure; treatment outcome |
顯示於: | 醫學系 |
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