Prognostic Value of EGFR 19-del and 21-L858R Mutations in Patients with Non-small Cell Lung Cancer

Overview

Journal Oncol Lett

Specialty Oncology

Date 2019 Sep 14

PMID 31516600

Citations 30

Authors

Weiwei Hong

Qiuji Wu

Junhong Zhang

Yunfeng Zhou

Affiliations

Soon will be listed here.

Abstract

Previous studies have demonstrated a significant difference in clinical characteristics between patients with non-small cell lung cancer (NSCLC) harboring exon 19 deletion (19-del) and an exon point mutation (21-L858R) in EGFR. The present retrospective study aimed to investigate the differential prognosis in patients with NSCLC harboring exon 19-del and 21-L858R mutations. The clinical and follow-up data of 137 patients treated at the Zhongnan Hospital of Wuhan University (Wuhan, Hubei, China) between August 2012 and August 2016, who were diagnosed with stage IIIB-IV NSCLC harboring either exon 19-del or 21-L858R mutations, were analyzed. The patients were divided into the first-line tyrosine kinase inhibitor (TKI), first-line chemotherapy and second-line TKI treatment groups. The median progression-free survival (PFS) time of patients harboring the exon 19-del mutation was significantly improved compared with that in patients harboring the 21-L858R mutation (11.3 vs. 8.8 months, respectively; P=0.017) following first-line TKI treatments. However, no significant difference in the median PFS time was observed between the exon 19-del and 21-L858R groups following the first-line chemotherapy or second-line TKI treatment. In patients with the exon 19-del, first-line TKI treatment achieved an increased objective response rate (ORR; 51.9 vs. 18.5%; P=0.004) and disease control rate (96.2 vs. 77.8%; P=0.030), and a longer PFS time (11.3 vs. 8.0 months; P=0.034) compared with that in the patients following first-line chemotherapy. First- and second-line TKI treatment achieved a similar PFS time (11.3 vs. 11.0 months, respectively; P=0.140). However, in patients with the 21-L858R mutation, the first-line TKI therapy and first-line chemotherapy groups exhibited a similar PFS time (8.8 vs. 3.5 months, respectively; P=0.063), while the second-line TKI treatment group exhibited a significantly longer PFS time compared with the first-line TKI treatment group (13.6 vs. 8.8 months, respectively; P=0.030). There was a differential sensitivity to treatment between patients harboring the exon 19-del and 21-L858R mutations. Therefore, chemotherapy may increase the sensitivity to TKIs in patients harboring the 21-L858R mutation.

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