| 邵 岚,王文娴,石志永.EGFR T790M突变丰度对奥希替尼治疗晚期非小细胞肺癌疗效的影响[J].肿瘤学杂志,2020,26(7):575-581. |
| EGFR T790M突变丰度对奥希替尼治疗晚期非小细胞肺癌疗效的影响 |
| Relationship Between Abundance of EGFR T790M Mutation and Efficacy of Osimertinib in Treatment of Advanced Non-small Cell Lung Cancer Patients |
| 投稿时间：2020-04-07 |
| DOI：10.11735/j.issn.1671-170X.2020.07.B002 |
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| 中文关键词: 非小细胞肺癌 奥希替尼 突变丰度 疗效预测 |
| 英文关键词:non-small cell lung cancer osimertinib mutant abundance efficacy prediction |
| 基金项目:浙江省中医药科研基金(2019ZB017, 2020ZA023)、浙江省卫生厅一般研究课题(2015122748)、浙江省自然科学基金课题(LSY19A010001) |
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| 中文摘要: |
| 摘 要：［目的］ 分析奥希替尼治疗晚期非小细胞肺癌疗效，并探索ddPCR方法外周血检测表皮生长因子（epidermal growth factor，EGFR）T790M突变的丰度与奥希替尼疗效之间的关系。［方法］ 回顾性分析104例接受奥希替尼治疗的Ⅲb~Ⅳ期非小细胞癌肺癌患者，采用ddPCR法测定外周血T790M突变丰度，采用Kaplan-Meier法和Cox模型进行生存预后分析，并探索疗效相关T790M突变丰度的界值。［结果］ 外周血EGFR T790M突变丰度中位值为0.89%（0.02%~35.10%）。将突变丰度分为＜5.00%和≥5.00%两组，客观缓解率分别为46.5%和88.9%（P=0.001），中位无进展生存期分别为8.80个月和21.83个月（P=0.039）。Cox回归分析显示，初治时基因类型（EGFR 19外显子缺失和21外显子L858R突变）、PS评分、外周血EGFR T790M突变丰度分组（＜5.00%和≥5.00%）是奥希替尼治疗患者PFS的独立影响因素。［结论］ EGFR T790M突变丰度可能可预测奥希替尼治疗的晚期EGFR T790M突变NSCLC患者的有效率和无进展生存期。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the relationship between abundance of EGFR T790M mutation and the efficacy of osimertinib in treatment of patients with advanced non-small cell lung cancer(NSCLC). ［Methods］ One hundred and four stage Ⅲb~Ⅳ NSCLC patients treated with osimertinib were included in the study. The abundance of peripheral blood T790M mutation as determined with ddPCR method，the survival of patients was analyzed with Kaplan-Meier method，the related factors for patients’ survival were analyze with Cox model，the cutoff value of T790M mutation abundance for predicting therapeutic efficacy was explored.［Results］ The median mutation abundance of peripheral blood EGFR T790M was 0.89%(0.02%~35.10%). For patients with mutation abundance <5.00% and ≥5.00%，the objective response rate(ORR) was 46.5% and 88.9%(P=0.001)，and the median progression-free survival(PFS) was 8.80 months and 21.83 months(P=0.039)，respectively. Cox regression analysis showed that genotype(EGFR 19 exon deletion and 21 exon L858R mutation)，PS score，and peripheral blood EGFR T790M mutation abundance(< 5.00% and ≥5.00%) were independent influencing factors for PFS in patients with osimertinib treatment. ［Conclusion］ The abundance of EGFR T790M mutation determined by ddPCR may predict the response and progression-free survival in patients with advanced NSCLC treated with osimertinib. |
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