中国肺癌杂志
中國肺癌雜誌
중국폐암잡지
CHINESE JOURNAL OF LUNG CANCER
2015年
8期
493-499
,共7页
杨雪%陈含笑%张弘%段建春%安彤同%赵军%卓明磊%吴梅娜%王洁
楊雪%陳含笑%張弘%段建春%安彤同%趙軍%卓明磊%吳梅娜%王潔
양설%진함소%장홍%단건춘%안동동%조군%탁명뢰%오매나%왕길
肺肿瘤%EGFR%少见突变%靶向治疗
肺腫瘤%EGFR%少見突變%靶嚮治療
폐종류%EGFR%소견돌변%파향치료
Lung neoplasms%EGFR%Uncommon mutation%Target therapy
背景与目的表皮生长因子受体（epidermal growth factor receptor,EGFR）敏感性突变是EGFR酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）的有效预测因子。85%-90%敏感性突变发生于19缺失突变及21外显子L858R突变。常见EGFR敏感性突变患者EGFR-TKIs治疗的客观缓解率（objective response rate, ORR）和无病进展生存时间（progression-free survival, PFS）显著延长，可分别达70%-80%和9个月-14个月。但EGFR-TKIs对于EGFR少见突变（uncommon mutations）的疗效尚不明确。本研究旨在探讨EGFR少见突变的临床病理特征及EGFR-TKIs治疗的远近期疗效。方法收集2010年4月-2015年4月北京大学肿瘤医院胸部肿瘤内科24例少见EGFR突变患者的临床资料，分析少见EGFR突变的临床病理特征及与TKIs疗效及PFS之间的关系。结果24例携带少见突变的患者中，单突变者15例，双突变者9例。15例单突变中，S768I、L861Q、20外显子插入突变、G719X分别为4例、4例、3例、2例。双突变中以S768I合并G719X最为常见（3/9）。在接受EGFR-TKIs治疗的13例患者中，ORR为46.1%（6/13），疾病控制率（disease control rate, DCR）为76.9%（10/13），中位PFS为7.4个月。结论作为特殊类型的EGFR突变，EGFR少见突变对于一代EGFR-TKIs的敏感性介于EGFR敏感性突变和EGFR野生型之间。相对于一代EGFR-TKIs而言，二代EGFR-TKIs可能更适用于EGFR少见突变的治疗。。
揹景與目的錶皮生長因子受體（epidermal growth factor receptor,EGFR）敏感性突變是EGFR酪氨痠激酶抑製劑（tyrosine kinase inhibitors, TKIs）的有效預測因子。85%-90%敏感性突變髮生于19缺失突變及21外顯子L858R突變。常見EGFR敏感性突變患者EGFR-TKIs治療的客觀緩解率（objective response rate, ORR）和無病進展生存時間（progression-free survival, PFS）顯著延長，可分彆達70%-80%和9箇月-14箇月。但EGFR-TKIs對于EGFR少見突變（uncommon mutations）的療效尚不明確。本研究旨在探討EGFR少見突變的臨床病理特徵及EGFR-TKIs治療的遠近期療效。方法收集2010年4月-2015年4月北京大學腫瘤醫院胸部腫瘤內科24例少見EGFR突變患者的臨床資料，分析少見EGFR突變的臨床病理特徵及與TKIs療效及PFS之間的關繫。結果24例攜帶少見突變的患者中，單突變者15例，雙突變者9例。15例單突變中，S768I、L861Q、20外顯子插入突變、G719X分彆為4例、4例、3例、2例。雙突變中以S768I閤併G719X最為常見（3/9）。在接受EGFR-TKIs治療的13例患者中，ORR為46.1%（6/13），疾病控製率（disease control rate, DCR）為76.9%（10/13），中位PFS為7.4箇月。結論作為特殊類型的EGFR突變，EGFR少見突變對于一代EGFR-TKIs的敏感性介于EGFR敏感性突變和EGFR野生型之間。相對于一代EGFR-TKIs而言，二代EGFR-TKIs可能更適用于EGFR少見突變的治療。。
배경여목적표피생장인자수체（epidermal growth factor receptor,EGFR）민감성돌변시EGFR락안산격매억제제（tyrosine kinase inhibitors, TKIs）적유효예측인자。85%-90%민감성돌변발생우19결실돌변급21외현자L858R돌변。상견EGFR민감성돌변환자EGFR-TKIs치료적객관완해솔（objective response rate, ORR）화무병진전생존시간（progression-free survival, PFS）현저연장，가분별체70%-80%화9개월-14개월。단EGFR-TKIs대우EGFR소견돌변（uncommon mutations）적료효상불명학。본연구지재탐토EGFR소견돌변적림상병리특정급EGFR-TKIs치료적원근기료효。방법수집2010년4월-2015년4월북경대학종류의원흉부종류내과24례소견EGFR돌변환자적림상자료，분석소견EGFR돌변적림상병리특정급여TKIs료효급PFS지간적관계。결과24례휴대소견돌변적환자중，단돌변자15례，쌍돌변자9례。15례단돌변중，S768I、L861Q、20외현자삽입돌변、G719X분별위4례、4례、3례、2례。쌍돌변중이S768I합병G719X최위상견（3/9）。재접수EGFR-TKIs치료적13례환자중，ORR위46.1%（6/13），질병공제솔（disease control rate, DCR）위76.9%（10/13），중위PFS위7.4개월。결론작위특수류형적EGFR돌변，EGFR소견돌변대우일대EGFR-TKIs적민감성개우EGFR민감성돌변화EGFR야생형지간。상대우일대EGFR-TKIs이언，이대EGFR-TKIs가능경괄용우EGFR소견돌변적치료。。
Background and objective Epidermal growth factor receptor (EGFR) mutations occur more frequently in non-small cell lung cancer (NSCLC) of women, never smokers, Asian population and those with adenocarcinoma. Short in-frame deletion in exon 19 and L858R substitution are the most common mutations, which are closely associated with EGFR tyrosine kinase inhibitors (TKIs) treatment response. However, the therapeutic effects of EGFR-TKIs on NSCLC with uncom-monEGFR mutation subtypes remain unclear. hTe aim of this study is to investigate the clinicopathologic feature of uncom-monEGFR mutations and the outcomes of these patients.Methods Twenty-four patients that harbored uncommonEGFR mutations were included in this study. Clinicopathologic features of uncommonEGFR mutations and the outcomes of these patients were analyzed.Results Of the 24 patients, 13 received EGFR-TKIs treatment. hTe response rate of EGFR-TKIs treat-ment was 46.1%, and the median progression-free survival (PFS) was 7.4 months. Mutations on S768I and L861Q composed a major part (8 of 24) of uncommon mutations.Conclusions UncommonEGFR mutations constituted a unique part of the whole group ofEGFR mutations. hTeir composition and sensitivity to EGFR-TKIs were heterogeneous, which requires further assessment in a prospective study.
