Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations
BackgroundEGFR exon 20 insertions (EGFR ex20ins) constitute a heterogeneous subset of EGFR-activating alterations. However, the effectiveness of standard therapy in patients with EGFR ex20ins remains poor.MethodsIn our study, we retrospectively collected next-generation sequencing (NGS) data from 7,...
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.949304/full |
| _version_ | 1811185274400538624 |
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| author | Chao Shi Chao Shi Ruyue Xing Mengmeng Li Junnan Feng Junnan Feng Rui Sun Rui Sun Bing Wei Bing Wei Yongjun Guo Yongjun Guo Jie Ma Jie Ma Huijuan Wang |
| author_facet | Chao Shi Chao Shi Ruyue Xing Mengmeng Li Junnan Feng Junnan Feng Rui Sun Rui Sun Bing Wei Bing Wei Yongjun Guo Yongjun Guo Jie Ma Jie Ma Huijuan Wang |
| author_sort | Chao Shi |
| collection | DOAJ |
| description | BackgroundEGFR exon 20 insertions (EGFR ex20ins) constitute a heterogeneous subset of EGFR-activating alterations. However, the effectiveness of standard therapy in patients with EGFR ex20ins remains poor.MethodsIn our study, we retrospectively collected next-generation sequencing (NGS) data from 7,831 Chinese NSCLC patients and analyzed the relationship between EGFR ex20ins variations and medical records.ResultsOur data showed that EGFR ex20ins account for up to 3.5% of all EGFR mutation non-small-cell lung cancer (NSCLC) patients and 1.6% of all NSCLC patients in China. Thirty-eight different variants of EGFR ex20ins were identified in 129 NSCLC patients. We observed that the patients with EGFR ex20ins may benefit from the anti-angiogenesis agents significantly (P = 0.027). In the EGFR ex20ins near-loop group, patients who received second-/third-generation EGFR-TKI therapy treatment as first-line treatment had a longer median progression-free survival (PFS) than those who initiated treatment with first-generation EGFR-TKI or chemotherapy. Patients with co-mutations of EGFR ex20ins near-loop and TP53 tended to have a shorter OS in second-/third-generation EGFR-TKI therapy (P = 0.039). Additionally, median PFS was significantly longer in patients harboring EGFR ex20ins far-loop variants who received chemotherapy as a first-line setting (P = 0.037).ConclusionsOverall survival was significantly longer in EGFR ex20ins patients with anti-angiogenesis agents. For the choice of first-line strategy, NSCLC with EGFR ex20ins near-loop variants may benefit from second-/third-generation EGFR-TKI, while patients harboring EGFR ex20ins far-loop variants might have better outcomes from chemotherapy. TP53 could serve as a potential predictive marker in poor prognosis for EGFR ex20ins near-loop patients. |
| first_indexed | 2024-04-11T13:26:40Z |
| format | Article |
| id | doaj.art-66858e26ae60419aa3b833eaadafbdc5 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T13:26:40Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-66858e26ae60419aa3b833eaadafbdc52022-12-22T04:22:01ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.949304949304Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutationsChao Shi0Chao Shi1Ruyue Xing2Mengmeng Li3Junnan Feng4Junnan Feng5Rui Sun6Rui Sun7Bing Wei8Bing Wei9Yongjun Guo10Yongjun Guo11Jie Ma12Jie Ma13Huijuan Wang14Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaDepartment of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaHenan Key Laboratory of Molecular Pathology, Zhengzhou, ChinaDepartment of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, ChinaBackgroundEGFR exon 20 insertions (EGFR ex20ins) constitute a heterogeneous subset of EGFR-activating alterations. However, the effectiveness of standard therapy in patients with EGFR ex20ins remains poor.MethodsIn our study, we retrospectively collected next-generation sequencing (NGS) data from 7,831 Chinese NSCLC patients and analyzed the relationship between EGFR ex20ins variations and medical records.ResultsOur data showed that EGFR ex20ins account for up to 3.5% of all EGFR mutation non-small-cell lung cancer (NSCLC) patients and 1.6% of all NSCLC patients in China. Thirty-eight different variants of EGFR ex20ins were identified in 129 NSCLC patients. We observed that the patients with EGFR ex20ins may benefit from the anti-angiogenesis agents significantly (P = 0.027). In the EGFR ex20ins near-loop group, patients who received second-/third-generation EGFR-TKI therapy treatment as first-line treatment had a longer median progression-free survival (PFS) than those who initiated treatment with first-generation EGFR-TKI or chemotherapy. Patients with co-mutations of EGFR ex20ins near-loop and TP53 tended to have a shorter OS in second-/third-generation EGFR-TKI therapy (P = 0.039). Additionally, median PFS was significantly longer in patients harboring EGFR ex20ins far-loop variants who received chemotherapy as a first-line setting (P = 0.037).ConclusionsOverall survival was significantly longer in EGFR ex20ins patients with anti-angiogenesis agents. For the choice of first-line strategy, NSCLC with EGFR ex20ins near-loop variants may benefit from second-/third-generation EGFR-TKI, while patients harboring EGFR ex20ins far-loop variants might have better outcomes from chemotherapy. TP53 could serve as a potential predictive marker in poor prognosis for EGFR ex20ins near-loop patients.https://www.frontiersin.org/articles/10.3389/fonc.2022.949304/fullEGFR exon20 insertionnear loopfar loopclinical treatment outcomesNSCLC |
| spellingShingle | Chao Shi Chao Shi Ruyue Xing Mengmeng Li Junnan Feng Junnan Feng Rui Sun Rui Sun Bing Wei Bing Wei Yongjun Guo Yongjun Guo Jie Ma Jie Ma Huijuan Wang Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations Frontiers in Oncology EGFR exon20 insertion near loop far loop clinical treatment outcomes NSCLC |
| title | Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations |
| title_full | Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations |
| title_fullStr | Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations |
| title_full_unstemmed | Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations |
| title_short | Real-world clinical treatment outcomes in Chinese non-small cell lung cancer with EGFR exon 20 insertion mutations |
| title_sort | real world clinical treatment outcomes in chinese non small cell lung cancer with egfr exon 20 insertion mutations |
| topic | EGFR exon20 insertion near loop far loop clinical treatment outcomes NSCLC |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.949304/full |
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