EGFR-TKI对少见EGFR 21L861Q突变的晚期非小细胞肺癌患者的治疗效果

Efficacy of EGFR tyrosine kinase inhibitors in advanced non-small cell lung cancer patients with uncommon EGFR 21L861Q mutation

目的·评价表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)对少见EGFR基因第21外显子L861Q(21L861Q)突变的晚期非小细胞肺癌(NSCLC)患者的治疗效果。方法·收集2011年6月—2015年3月在上海交通大学附属胸科医院接受EGFR-TKI治疗的EGFR 21L861Q突变的21例ⅢB或Ⅳ期NSCLC患者的临床资料。对TKI治疗的客观缓解率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)和总生存期(OS)进行回顾性分析。结果·接受过TKI治疗(一线+二线+三线)患者的ORR和DCR分别为42.9%和66.7%;PFS和OS分别为7.03个月(95%CI:5.50~8.69)和22.80个月(95%CI:16.22~25.65)。结论·EGFR-TKI对少见EGFR21L861Q突变的晚期NSCLC患者的治疗有效,但是效果不如常见突变。

Objective · To evaluate the efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKI） in non small cell lung cancer （NSCLC） patients with uncommon EGFR 21L861Q mutation. Methods · Between June 2011 and Marth 2015, clinical data of 21 stage Ⅲ B/ Ⅳ NSCLC patients who received EGFR-TKI harboring uncommon 21L861Q mutation in EGFR at the Shanghai Chest Hospital were collected. Objective response rate （ORR）, disease control rate （DCR）, progression-free survival （PFS ） and overall survival （OS ） of the patients under TKI therapy were retrospectively analyzed. Results · ORR and DCR of the patients under TKIs therapy （first-line＋second-line＋third-line） were 42.9% and 66.7% respectively. PFS and OS of patients who received therapy that consisted of EGFR-TKIs （first-line＋second-line＋third-line） were 7.03 months （95% CI, 5.50-8.69） and 22.80 months （95% CI, 16.22-25.65）. Conclusion · Our post-hoc analyses demonstrated that EGFR-TKIs showed activity in patients with uncommon EGFR 21L861Q-mutant NSCLC, less effective than in those with common mutations.