| 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. |
| 非小细胞肺癌EGFR基因少见突变G719X的治疗模式探索性分析 |
| 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 |
| DOI：10.1007/s10330-019-0333-3 |
| 中文关键词: 肺肿瘤；EGFR；少见突变；G719X；靶向治疗 |
| 英文关键词: ?lung neoplasms; EGFR; uncommon mutation; G719X; target therapy |
| 基金项目: |
| 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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| 中文摘要: |
| 背景与目的G719X突变是EGFR基因最常见的少见突变，是位于18外显子的点突变，常见三种亚型为G719A/G719C/G719S。本研究探讨了G719X突变患者的临床病理特征及对EGFR-TKIs和化疗的疗效，以及不同治疗模式所带来的生存获益，为临床治疗提供依据。
方法 收集2014年9月-2018年7月于首都医科大学附属北京胸科医院确诊并采用ARMS-PCR技术检测确定的41例G719X突变患者的临床资料，分析G719X突变患者的临床病理特征及与不同治疗模式疗效及PFS之间的关系。
结果 41例G719X突变中，单纯G719X占24例（58.5%），各种复合突变占17例（41.5%），包括G719X/S768I、G719X/L861Q、G719X/19del和G719/c-Met。一线靶向治疗的ORR为50％（6/12）；DCR为 83.3％（10/12），中位PFS为9个月。前一线接受过EGFR-TKIs治疗并耐药后，后续其他EGFR-TKIs依然可获得较高的ORR （71.4%，5/7）和DCR （100%，7/7），中位PFS为8个月。 全身化疗的ORR为33.3％（2/6），DCR为100%（6/6），中位PFS为6个月。
结论 G719X是一种EGFR基因敏感突变，对多种EGFR-TKIs敏感，可接受多线续惯EGFR-TKIs治疗，以一代TKIs后续二三代为主，且对化疗亦显示出较好的疗效。 |
| 英文摘要: |
| ?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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