Distribution characteristics of plasma EGFR T790M mutation in patients with advanced NSCLC treated with three first-generation EGFR-TKIs

doi:10.3877/cma.j.issn.1674-6902.2021.02.007

Abstract

Abstract:

Objective

The purpose of this study is to study the distribution characteristics of T790M mutations in advanced NSCLC patients with epidermal growth factor receptor (EGFR)-sensitive mutations in the real world after receiving first-line treatment with three different generations of EGFR-TKIs.

Methods

Between June 2017 and June 2019, a total of 557 patients with NSCLC were enrolled in this study. 145 patients with advanced non-small cell lung cancer (NSCLC) diagnosed with histopathology or cytology with EGFR-sensitive mutations were randomized to gefitinib, erlotinib, icotinib first-line treatment. By χ² test, Kaplan-Meier method, retrospectively analyze the probability of acquiring T790M after taking first-line TKIs (gefitinib, Erlotinib, icotinib) and clinical features of patients with T790M mutation.

Results

Of the 557 patients screened, 145 fulfilled the inclusion criteria and were enrolled in this retrospective analysis. In these patients, 56 patients received gefitinib in the first line, 16 received erlotinib, and 73 received icotinib. Super-ARMS test results showed that the overall incidence of T790M mutation was 40% (58/145), including 41.07% (23/56) in the gefitinib group and 31.25 in the erlotinib group % (5/16), 41.10% (30/73) in the icotinib group. There was no statistical difference in the incidence of T790M mutation among the three groups. However, patients with lung adenocarcinoma (P=0.0001) and patients with an initial EGFR mutation of 19del (P=0.0014) had a higher frequency of T790M mutations. Among the T790M positive population, the median PFS of gefitinib, erlotinib and ectinib was: 11, 18 and 12 m. The 1-year and 2-year detection rates of T790M mutation were 6.25%, 29.09%, 24.66% and 31.24, 45.45% and 41.09%, no statistical difference between the groups.

Conclusion

There was no significant difference in the incidence of T790M mutation among the advanced NSCLC treatment with first-generation EGFR-TKI. In the T790M positive population, the median PFS and the 1-year and 2-year detection rates of T790M mutation were no statistical difference between the groups. This further indicates the necessity of refined management of NSCLC patients.

Key words: EGFR-TKI, blood T790M mutation, Mutation rate, Advanced non-small cell lung cancer

Guangming Fu, Ping Liu, Fang Wu, Xiaokang Xiang, Chunhong Hu, Xianling Liu, Hui Xiong. Distribution characteristics of plasma EGFR T790M mutation in patients with advanced NSCLC treated with three first-generation EGFR-TKIs[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(02): 169-173.

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Figures/Tables 3

References 25

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临床资料		例数	T790M
临床资料		例数	阳性	阴性	χ²值	P值
性别					0.600	>0.05
	男	53	19	34
	女	92	39	53
年龄					0.353	>0.05
	≤40岁	8	4	4
	>40岁	137	54	83
吸烟					0.346	>0.05
	吸烟	36	12	24
	非吸烟	109	46	63
初始突变					10.23	<0.05
	19Del	70	38	32
	L858R	66	18	48
病理					22.60	<0.05
	腺癌	110	56	54
	非腺癌	35	2	33

临床资料		例数	T790M
临床资料		例数	阳性	阴性	χ²值	P值
性别					0.600	>0.05
	男	53	19	34
	女	92	39	53
年龄					0.353	>0.05
	≤40岁	8	4	4
	>40岁	137	54	83
吸烟					0.346	>0.05
	吸烟	36	12	24
	非吸烟	109	46	63
初始突变					10.23	<0.05
	19Del	70	38	32
	L858R	66	18	48
病理					22.60	<0.05
	腺癌	110	56	54
	非腺癌	35	2	33

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