EGFR T790M突变丰度对阿美替尼治疗晚期非小细胞肺癌疗效的影响

Add to Favorite Relationship between abundance of EGFR T790M mutation and efficacy of Almonertinib in the treatment of advanced non-small cell lung cancer patients

目的分析阿美替尼治疗晚期非小细胞肺癌疗效,并探索EGFR T790M突变丰度与阿美替尼疗效之间的关系。方法回顾性分析52例接受阿美替尼治疗的经一/二代EGFR-TKIs耐药的Ⅲ期或Ⅳ期EGFR T790M突变的非小细胞肺癌患者,采用Kaplan-Meier法及Cox模型进行预后分析,并通过ROC曲线分析确定疗效相关的T790M突变丰度临界值。结果入组肺癌患者接受阿美替尼治疗的ORR为48.1%,DCR为94.2%。外周血T790M丰度中位值为1.94%。阿美替尼治疗患者的丰度最佳临界值为2.05%,将突变丰度≥2.05%的患者纳入高丰度组(25例),<2.05%的患者纳入低丰度组(27例),高丰度值和低丰度值的ORR分别为84.0%和14.8%,PFS分别为12.8个月和7.2个月,OS分别为22.2个月和18.3个月。Cox回归分析显示,基因类型、性别、吸烟史、是否脑转移均不是阿美替尼治疗患者PFS的影响因素,外周血EGFR T790M突变丰度是PFS的独立影响因素。结论EGFR T790M突变丰度可能可预测阿美替尼治疗的晚期EGFR T790M突变NSCLC患者的有效率和生存期。

Objective To analyze the efficacy of Almonertinib in the treatment of advanced non-small cell lung cancer,and to explore the relationship between the abundance of EGFR T790M mutation and the efficacy of Almonertinib.Methods A retrospective analysis of 52 patients with stageⅢand stage-Ⅳnon-small cell lung cancer accompanied with EGFR T790M mutation who were treated with Almonertinib and were resistant to EGFR TKI in the first/second generation was carried out.The Kaplan-Meier method and Cox model were used to analyze the prognosis,and the critical value of T790M mutation abundance related to the efficacy was explored.Results The ORR and DCR of the patients with lung cancer who received the treatment of Almonertinib were 48.1%and 94.2%respectively.The median abundance of T790M in peripheral blood was 1.94%.The cutoff value of abundance in patients treated with Almonertinib was 2.05%.Patients with mutation abundance≥2.05%were included in the high abundance group(25 cases),and patients with mutation abundance<2.05%were included in the low abundance group(27 cases).The ORR of the high abundance group and the low abundance group was 84.0%and 14.8%respectively,and the PFS was 12.8 months and 7.2 months respectively,and the OS was 22.2 months and 18.3 months respectively.Cox regression analysis showed that gene type,sex,smoking history,and brain metastasis were not factors influencing PFS in patients treated with Almonertinib,and the EGFR T790M mutation abundance in peripheral blood was an independent influencing factor of PFS.Conclusion The abundance of EGFR T790M mutation may predict the effective rate and survival of patients with NSCLC with advanced EGFR T790M mutation treated with Almonertinib.