| Hua Zheng,Yuan Gao,Zan Liu,Zhe Qian,Tongmei Zhang,Jie Li,Hongmei Zhang,Qunhui Wang,Fanbin Hu,Baolan Li. Investigation of therapeutic modalities of G719X, ?an uncommon mutation in the EGFR gene ?in non-small cell lung cancer. Oncol Transl Med, 2019, 5: 91-97. |
| Investigation of therapeutic modalities of G719X, ?an uncommon mutation in the EGFR gene ?in non-small cell lung cancer |
| Received:January 28, 2019 Revised:April 22, 2019 |
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| KeyWord:?lung neoplasms; EGFR; uncommon mutation; G719X; target therapy |
| Author Name | Affiliation | E-mail | | Hua Zheng | Beijing Chest Hospital,Capital Medical University | zhenghua022@sina.com | | Yuan Gao | Beijing Chest Hospital,Capital Medical University | | | Zan Liu | Beijing Chest Hospital,Capital Medical University | | | Zhe Qian | Beijing Chest Hospital,Capital Medical University | | | Tongmei Zhang | Beijing Chest Hospital,Capital Medical University | | | Jie Li | Beijing Chest Hospital,Capital Medical University | | | Hongmei Zhang | Beijing Chest Hospital,Capital Medical University | | | Qunhui Wang | Beijing Chest Hospital,Capital Medical University | | | Fanbin Hu | Beijing Chest Hospital,Capital Medical University | hufanbin@sina.com | | Baolan Li | Beijing Chest Hospital,Capital Medical University | |
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| Abstract: |
| ?Objective G719X is the most frequently seen uncommon mutation of the epidermal growth factor
receptor (EGFR) gene, which is a point mutation at exon 18 with three common subtypes, G719A/G719C/
G719S. This study explored the clinicopathological characteristics of the G719X mutation and investigated
the efficacy of EGFR-tyrosine kinase inhibitor (TKI) treatment and chemotherapy in patients with the G719X
mutation; the survival rate after these different treatment modalities were then analyzed in order to provide
evidence for clinical treatment.
Methods Clinical data of 41 patients with the G719X mutation admitted in the Beijing Chest Hospital,
Capital Medical University from September 2014 to July 2018, were collected and the EGFR mutations
were detected by amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). The
clinicopathological characteristics of the G719X mutation were analyzed, and the relationship among the
G719X mutation, the efficacy of different treatment modalities, and the progression-free survival (PFS) was
analyzed.
Results Of the 41 cases, 24 (58.5%) were G719X single mutations and 17 (41.5%) were compound
mutations, including G719X/S768I, G719X/L861Q, G719X/19del, and G719X/c-Met compound mutation.
The objective response rate (ORR) of first-line EGFR-TKI therapy was 50% (6/12), the disease control rate
(DCR) was 83.3% (10/12), and the median PFS (mPFS) was 9 months. After resistance to EGFR-TKI in
the previous treatment, the ORR (71.4%, 5/7) and DCR (100%, 7/7) were still high following EGFR-TKIs,
by an mPFS of 8 months. The ORR of chemotherapy was 33.3% (2/6), the DCR was 100% (6/6), and the
mPFS was 6 months.
Conclusion G719X is an uncommon mutation of the EGFR gene and is sensitive to many EGFR-TKIs.
It can be treated with the second- or third-generation EGFR-TKIs after resistance to the first-generation
EGFR-TKIs. G719X mutation also showed favorable effect to chemotherapy. |
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