Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study
Abstract Background Clinical significance of various subtypes of epidermal growth factor receptor (EGFR) exon 19 deletion (ex19del) mutation in non‐small cell lung cancer (NSCLC) remains unclear. Methods We analyzed EGFR ex19del subtypes in NSCLC patients receiving first‐line tyrosine kinase inhibit...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Thoracic Cancer |
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| Online Access: | https://doi.org/10.1111/1759-7714.15108 |
| _version_ | 1797635925477425152 |
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| author | Yangchun Gu Jinyu Yu Haifeng Hu Hua Zhang Baoshan Cao Li Liang |
| author_facet | Yangchun Gu Jinyu Yu Haifeng Hu Hua Zhang Baoshan Cao Li Liang |
| author_sort | Yangchun Gu |
| collection | DOAJ |
| description | Abstract Background Clinical significance of various subtypes of epidermal growth factor receptor (EGFR) exon 19 deletion (ex19del) mutation in non‐small cell lung cancer (NSCLC) remains unclear. Methods We analyzed EGFR ex19del subtypes in NSCLC patients receiving first‐line tyrosine kinase inhibitor (TKI) therapy at our center (January 2018–June 2022) and correlated them with median progression‐free survival (mPFS) and median overall survival (mOS). Results We identified 17 different EGFR ex19del variants in 101 patients. Between the classic (E746_A750del, 64.4%) and nonclassic groups (the rest variants), no significant difference was observed in mPFS (13.5 vs. 19.3 months, p = 0.18) or mOS (44.1 vs. 77.0 months, p = 0.06). mPFS showed no significant difference between ex19del subgroups classified based on the presence of insertion (ex19delins), starting position or length of deletion. However, patients with ex19delins starting at E746 showed longer mPFS than the others (29.7 vs. 12.5 months, p = 0.04), and patients with ex19del of 15 nucleotides had shorter mOS than the others (44.1 vs. 77.0 months, p = 0.03). In multivariate analysis, ex19delins independently predicted a better PFS (HR = 0.311, p = 0.03); however, 15 nucleotide deletion was no longer associated with OS (HR = 0.181, p = 0.11). Secondary T790M mutation incidence was significantly higher in the ex19del subgroup starting at E746 than the others (64.7% vs. 30.8%, p = 0.04). Conclusions Our study revealed potential differences in TKI efficacy, resistance mechanism, and prognosis of various EGFR ex19del subtypes in NSCLC, underscoring the need for precise selection of first‐line therapy. |
| first_indexed | 2024-03-11T12:27:50Z |
| format | Article |
| id | doaj.art-cc41914c3c774dc890a2f2e47fca9aa5 |
| institution | Directory Open Access Journal |
| issn | 1759-7706 1759-7714 |
| language | English |
| last_indexed | 2024-03-11T12:27:50Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Thoracic Cancer |
| spelling | doaj.art-cc41914c3c774dc890a2f2e47fca9aa52023-11-06T07:15:22ZengWileyThoracic Cancer1759-77061759-77142023-11-0114313147316010.1111/1759-7714.15108Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort studyYangchun Gu0Jinyu Yu1Haifeng Hu2Hua Zhang3Baoshan Cao4Li Liang5Department of Medical Oncology and Radiation Sickness Peking University Third Hospital Beijing ChinaDepartment of Medical Oncology and Radiation Sickness Peking University Third Hospital Beijing ChinaDepartment of Oncology Yan'an Hospital of Traditional Chinese Medicine Shaanxi ChinaResearch Center of Clinical Epidemiology Peking University Third Hospital Beijing ChinaDepartment of Medical Oncology and Radiation Sickness Peking University Third Hospital Beijing ChinaDepartment of Medical Oncology and Radiation Sickness Peking University Third Hospital Beijing ChinaAbstract Background Clinical significance of various subtypes of epidermal growth factor receptor (EGFR) exon 19 deletion (ex19del) mutation in non‐small cell lung cancer (NSCLC) remains unclear. Methods We analyzed EGFR ex19del subtypes in NSCLC patients receiving first‐line tyrosine kinase inhibitor (TKI) therapy at our center (January 2018–June 2022) and correlated them with median progression‐free survival (mPFS) and median overall survival (mOS). Results We identified 17 different EGFR ex19del variants in 101 patients. Between the classic (E746_A750del, 64.4%) and nonclassic groups (the rest variants), no significant difference was observed in mPFS (13.5 vs. 19.3 months, p = 0.18) or mOS (44.1 vs. 77.0 months, p = 0.06). mPFS showed no significant difference between ex19del subgroups classified based on the presence of insertion (ex19delins), starting position or length of deletion. However, patients with ex19delins starting at E746 showed longer mPFS than the others (29.7 vs. 12.5 months, p = 0.04), and patients with ex19del of 15 nucleotides had shorter mOS than the others (44.1 vs. 77.0 months, p = 0.03). In multivariate analysis, ex19delins independently predicted a better PFS (HR = 0.311, p = 0.03); however, 15 nucleotide deletion was no longer associated with OS (HR = 0.181, p = 0.11). Secondary T790M mutation incidence was significantly higher in the ex19del subgroup starting at E746 than the others (64.7% vs. 30.8%, p = 0.04). Conclusions Our study revealed potential differences in TKI efficacy, resistance mechanism, and prognosis of various EGFR ex19del subtypes in NSCLC, underscoring the need for precise selection of first‐line therapy.https://doi.org/10.1111/1759-7714.15108EGFR exon 19 deletion subtypesnon‐small cell lung canceroverall survivalprogression‐free survivaltyrosine kinase inhibitor |
| spellingShingle | Yangchun Gu Jinyu Yu Haifeng Hu Hua Zhang Baoshan Cao Li Liang Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study Thoracic Cancer EGFR exon 19 deletion subtypes non‐small cell lung cancer overall survival progression‐free survival tyrosine kinase inhibitor |
| title | Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study |
| title_full | Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study |
| title_fullStr | Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study |
| title_full_unstemmed | Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study |
| title_short | Clinical outcomes of advanced NSCLC patients with different EGFR exon 19 deletion subtypes treated with first‐line tyrosine kinase inhibitors: A single‐center ambispective cohort study |
| title_sort | clinical outcomes of advanced nsclc patients with different egfr exon 19 deletion subtypes treated with first line tyrosine kinase inhibitors a single center ambispective cohort study |
| topic | EGFR exon 19 deletion subtypes non‐small cell lung cancer overall survival progression‐free survival tyrosine kinase inhibitor |
| url | https://doi.org/10.1111/1759-7714.15108 |
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