Molecular characteristics and clinical outcomes of EGFR exon 19 indel subtypes to EGFR TKIs in NSCLC patients
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Jian Su1, Wenzhao Zhong2, Xuchao Zhang1, Ying Huang1, Honghong Yan1, Jinji Yang2, Zhongyi Dong2, Zhi Xie1, Qing Zhou2, Xiaosui Huang1, Danxia Lu1, Wenqing Yan1 and Yi-Long Wu2
1Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Medical Research Center of Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
2Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Sciences, Guangzhou 510080, China
Yi-Long Wu, email: firstname.lastname@example.org
Keywords: non-small cell lung cancer; EGFR mutation; EGFR-TKI; EGFR exon 19 deletion; EGFR exon 19 insertion
Received: February 25, 2017 Accepted: September 03, 2017 Published: November 30, 2017
Patients with non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR) mutations (exon 19 deletions and L858R) benefit from EGFR tyrosine kinase inhibitors (TKIs). However, some researchers have reported that responses to TKIs differ by subtypes of EGFR exon 19 mutations. We retrospectively analyzed EGFR exon 19 deletion subtypes and their correlation with clinical outcomes of treatment with TKIs. A cohort of 2664 consecutive patients with NSCLC was enrolled. A total of 440 EGFR exon 19 deletions were defined as 39 subtypes. Among them, 158 patients with advanced lung adenocarcinoma with EGFR exon 19 deletion mutations received EGFR-TKIs. There were no significant differences in progression-free survival or overall survival among patients with non-LRE deletions, delE746, or delL747 (P = 0.463 and P = 0.464, respectively). Furthermore, two patients with EGFR exon19 insertion had durable response to EGFR-TKIs. In conclusion, EGFR exon 19 is highly fragile, resulting in many different deletion and insertion subtypes. There were no significant differences in clinical outcomes after TKI treatment across the different subtypes. It is necessary to attempt to identify all patients with exon 19 deletions so that they can be offered TKI treatment.
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