Abstract | OBJECTIVES: METHODS: Patients with non-small cell lung cancer (NSCLC) diagnosed at the Shanghai Chest Hospital between January 2010 and December 2016 were retrospectively reviewed. RESULTS: A total of 10,037 NSCLC patients tested for EGFR mutations were screened, with primary ASC accounting for 1.4% (139/10,037). Positive EGFR mutations were found in 51.1% (71/139) of ASC patients, including 67 sensitive mutations (19del or 21L858R) and four uncommon mutations (19del + 20T790M, 21L858R + 20T790M, 19L747P + 20Q787Q, and 21L861Q). Sensitive EGFR mutations occurred more frequently in younger (62.0 vs 65.0, p = 0.010), non-smoking (83.6% vs 57.8%, p = 0.002) women (56.7% vs 34.4%, p = 0.014). Among the 36 ASC patients with eligible survival data for the first-generation TKIs, the median progression-free survival (PFS) was 9.3 months (95% CI 6.7-11.9), which was rather similar to the data of adenocarcinoma (9.3 vs 11.4 months, p = 0.294) in our institution as opposed to squamous cell carcinoma (9.3 vs 4.9 months, p < 0.001). The objective response rate (ORR) was 37.9% (11/29), and the disease control rate (DCR) was 86.2% (25/29). After progression on the initial EGFR TKIs, 42.1% of the cases (8/19) had an EGFR T790M mutation detected. A median PFS of 10.2 months (95% CI 5.8-14.5, n = 8) was achieved with treatment using the third-generation TKI. The ORR and DCR were 37.5% (3/8) and 100% (8/8), respectively. The median overall survival reached 38.3 months (95% CI 13.7-62.9). CONCLUSIONS: Targeted therapy showed remarkable efficacy in ASC patients harboring sensitive EGFR mutations, comparable to adenocarcinoma. The application of the third-generation TKI provided an option to prolong survival.
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Authors | Minjuan Hu, Bo Zhang, Jianlin Xu, Shuyuan Wang, Yiming Zhao, Lele Zhang, Baohui Han |
Journal | Molecular diagnosis & therapy
(Mol Diagn Ther)
Vol. 23
Issue 6
Pg. 773-779
(12 2019)
ISSN: 1179-2000 [Electronic] New Zealand |
PMID | 31713818
(Publication Type: Journal Article)
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Chemical References |
- Acrylamides
- Aniline Compounds
- Protein Kinase Inhibitors
- osimertinib
- EGFR protein, human
- ErbB Receptors
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Topics |
- Acrylamides
(therapeutic use)
- Age Factors
- Aged
- Aniline Compounds
(therapeutic use)
- Carcinoma, Adenosquamous
(drug therapy, genetics)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, genetics)
- ErbB Receptors
(drug effects, genetics)
- Female
- Humans
- Lung Neoplasms
(drug therapy, genetics)
- Male
- Middle Aged
- Mutation
- Protein Kinase Inhibitors
(therapeutic use)
- Sex Characteristics
- Survival Analysis
- Treatment Outcome
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