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 NameAffiliationE-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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