https://scholars.lib.ntu.edu.tw/handle/123456789/494885
標題: | Afatinib is effective in the treatment of lung adenocarcinoma with uncommon EGFR p.L747P and p.L747S mutations | 作者: | SHENG-KAI LIANG JEN-CHUNG KO CHIH-HSIN YANG JIN-YUAN SHIH |
公開日期: | 2019 | 出版社: | Elsevier Ireland Ltd | 卷: | 133 | 起(迄)頁: | 103-109 | 來源出版物: | Lung Cancer | 摘要: | Objectives: Epidermal growth factor receptor (EGFR)tyrosine kinase inhibitors (TKIs)are used as first-line standard treatment for advanced lung adenocarcinoma with mutant EGFR. Nevertheless, few studies have demonstrated the efficacy of first- and second-generation EGFR TKIs in patients harboring the uncommon p.L747P and p.L747S mutations in exon 19 of EGFR. Materials and methods: From 2005–2018, we identified patients with lung adenocarcinoma with EGFR p.L747P or p.L747S mutations using DNA and cDNA sequencing or commercial kits and recorded their clinical data. Published data pertaining to these mutations were also reviewed. Results: Twelve eligible patients were enrolled at National Taiwan University Hospital (NTUH), and ten additional patients were identified in published literature. In NTUH cohort, the direct DNA sequencing had a 60.0% (3 of 5 patients)false-negative rate, and use of commercial kits all caused misidentification of EGFR p.L747P or p.L747S. Of the 7 patients receiving EGFR TKI treatment, five stage-IV lung adenocarcinoma patients that received afatinib had a 80.0% objective response rate (ORR), while two patients administered gefitinib or erlotinib showed a 0% ORR. The median progression-free survival (PFS)rates were 11.97 and 0.92 months (P = 0.012)for afatinib and gefitinib/erlotinib, respectively. No patients (0%)acquired p.T790 M resistance after failure of afatinib (n = 3). Of 10 patients harboring EGFR p.L747P from published literature, six patients used first-generation EGFR TKIs as treatment also showed 0% ORR and 1.00 month median PFS. Conclusions: Patients with the uncommon EGFR mutations p.L747P and p.L747S could be incorrectly classified as having wild-type EGFR or a 19DEL when using direct DNA sequencing or commercial kits. Moreover, use of afatinib may provide significantly improved PFS in patients with advanced lung adenocarcinoma with one of these two EGFR mutations. ? 2019 Elsevier B.V. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85065893640&doi=10.1016%2fj.lungcan.2019.05.019&partnerID=40&md5=4884f13adbb71c784659811c71cbb076 https://scholars.lib.ntu.edu.tw/handle/123456789/494885 |
ISSN: | 0169-5002 | DOI: | 10.1016/j.lungcan.2019.05.019 | SDG/關鍵字: | afatinib; complementary DNA; epidermal growth factor receptor; erlotinib; gefitinib; leucine; proline; serine; afatinib; antineoplastic agent; EGFR protein, human; epidermal growth factor receptor; adult; aged; Article; cancer chemotherapy; cancer resistance; cancer staging; cancer survival; clinical article; cohort analysis; DNA sequence; drug efficacy; drug response; EGFR gene; female; gene mutation; human; human tissue; lack of drug effect; lung adenocarcinoma; male; middle aged; priority journal; progression free survival; treatment planning; trend study; very elderly; genetics; lung adenocarcinoma; lung tumor; mortality; mutation; survival analysis; Adenocarcinoma of Lung; Adult; Afatinib; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; ErbB Receptors; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mutation; Neoplasm Staging; Survival Analysis |
顯示於: | 腫瘤醫學研究所 |
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