晚期非小细胞肺癌患者肿瘤突变负荷与靶向治疗疗效的相关性

Correlation Between Tumor Mutation Load and Therapeutic Effect of Targeted Therapy in Patients With Advanced Non-Small Cell Lung Cancer

目的探讨晚期非小细胞肺癌患者肿瘤突变负荷与靶向治疗疗效相关性。方法选择2019年1—12月的77例晚期非小细胞肺癌患者,对所有患者的肿瘤样本进行DNA提取,并进行二代测序,根据测序结果进行肿瘤突变负荷计算,将所有患者分为42例高肿瘤突变负荷组和35例低中肿瘤突变负荷组,分析两组的基因突变信息,对两组均进行靶向治疗,分别为靶向EGFR和靶向TP53以及克唑替尼等治疗,分析两组的无进展生存期。结果高肿瘤突变负荷组TP53突变高于低中肿瘤突变负荷组(P <0.05),两组EGFR突变情况差异无统计学意义(P> 0.05),靶向EGFR以及克唑替尼治疗的低中肿瘤突变负荷组无进展生存期高于高肿瘤突变负荷组(P <0.05),靶向TP53治疗的无进展生存期没有差异(P> 0.05)。结论晚期非小细胞肺癌患者肿瘤突变负荷与靶向治疗疗效具有密切相关性,低中肿瘤突变负荷使用靶向治疗效果更好,且TP53靶向治疗与肿瘤突变负荷治疗效果无关性,靶向EGFR以及克唑替尼治疗与肿瘤突变负荷具有密切相关性,本研究为临床晚期非小细胞肺癌的治疗提高有价值的数据。

Objective To investigate the relationship between tumor mutation load and the therapeutic effect of targeted therapy in patients with advanced non-small cell lung cancer.Methods From January 2019 to December 2019,77 patients with advanced non-small cell lung cancer were selected.DNA was extracted from tumor samples of all patients and sequenced in the second generation.According to the results of sequencing,the tumor mutation load was calculated.All patients were divided into 42 patients with high tumor mutation load group and 35 patients with low and medium tumor mutation load group.The gene mutation information of the two groups was analyzed Both groups were treated with targeted therapy,including EGFR,TP53 and clozatinib,respectively.The progression free survival of the two groups was analyzed.Results TP53 mutation in the high tumor mutation load group was higher than that in the low and medium tumor mutation load group(P<0.05).There was no significant difference in EGFR mutation between the two groups(P>0.05).The progression free survival of the low and medium tumor mutation load group targeted at EGFR and clozatinib was higher than that of the high tumor mutation load group(P<0.05).There was no difference in progression free survival of the targeted TP53 treatment(P>0.05).Conclusion There is a close relationship between tumor mutation load and target therapy effect in patients with advanced non-small cell lung cancer.The target therapy effect of low and medium tumor mutation load is better,and TP53 target therapy has nothing to do with the effect of tumor mutation load.The target therapy of EGFR and crezotinib has a close relationship with tumor mutation load.This study is for the patients with advanced non-small cell lung cancer treatment improves valuable data.