Comparison of pattern of disease progression and prevalence of acquired T790M mutation in Malaysia patients with EGFR mutant lung adenocarcinoma upon failure of first-line afatinib, gefitinib and erlotinib
| Autor: | Chee Shee Chai, Chong-Kin Liam, Gwo Fuang Ho, O. Po Lin, Mau Ern Poh, Jiunn Liang Tan, Yong Kek Pang, Chee Kuan Wong, Adlinda Alip |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty Lung medicine.diagnostic_test biology business.industry Afatinib Hematology medicine.disease respiratory tract diseases T790M Gefitinib medicine.anatomical_structure Internal medicine Biopsy medicine biology.protein Adenocarcinoma Erlotinib Epidermal growth factor receptor business medicine.drug |
| Zdroj: | Annals of Oncology. 30:ix167 |
| ISSN: | 0923-7534 |
| DOI: | 10.1093/annonc/mdz437.020 |
| Popis: | Background Patients receiving first-line afatinib, gefitinib or erlotinib for epidermal growth factor receptor (EGFR) mutant advanced non-small cell lung cancer develop progression of disease (PD) after an average of 9-13 months. Methods A retrospective analysis of PD pattern and prevalence of acquired T790M mutation among patients failing first-line afatinib versus gefitinib or erlotinib at University Malaya Medical Centre from 1st January 2015 to 31th December 2018. Results Of 87 patients who developed PD while on first-line EGFR-tyrosine kinase inhibitor (TKI) treatment, 19 (21.8%) were on afatinib, 49 (56.3%) were on gefitinib, and 19 (21.8%) were on erlotinib. The median progression-free survival (mPFS) of these patients is as shown in the table. Of 20 patients (23.0%) who developed new symptomatic brain metastases, one (5.0%) had new leptomeningeal metastases, three (15.0%) had both new leptomeningeal metastases and solid brain metastases, and the remaining 16 (80.0%) had new solid brain metastases only. New leptomeningeal metastases occurred in one patient treated with afatinib and three patients treated with gefitinib. Forty-nine patients (56.3%) were investigated for acquired T790M mutation either by plasma biopsy or tissue biopsy or both. The prevalence of acquired T790M mutation was 61.2%. There was no difference in the pattern of PD or prevalence of acquired T790M mutation among patients treated with afatinib, gefitinib or erlotinib. Table . 494P Pattern of PD Patients with PD (n = 87) Afatinib (n = 19) Gefitinib (n = 49) Erlotinib (n = 19) p-value Median PFS, months 11.0 13.1 10.9 7.8 0.479 New brain metastases, No. (%) Yes No 20 (23.0) 67 (77.0) 5 (26.3) 14 (73.7) 12 (24.5) 37 (75.5) 3 (15.8) 16 (84.2) 0.692 New solid brain lesion metastases, No (%) Yes No 19 (21.8) 68 (78.2) 4 (21.1) 15 (78.9) 12 (24.5) 37 (75.5) 3 (15.5) 16 (84.2) 0.735 New leptomeningeal metastases, No. (%) Yes No 4 (4.6) 83 (95.4) 1 (5.2) 18 (94.8) 3 (6.1) 46 (93.9) 0 19 (100) 0.550 No. of patients tested for acquired T790M mutation n = 49 n = 14 n = 27 n = 8 p-value Acquired T790M mutation detected, No. (%) Yes No 30 (61.2) 19 (38.8) 9 (64.3) 5 (35.7) 16 (59.3) 11(40.7) 5 (62.5) 3 (37.5) 0.949 Conclusions New leptomeningeal metastases were uncommon in patients receiving first-line EGFR-TKI. The choice of first-line first- or second generation EGFR-TKI did not influence the pattern of PD and prevalence of acquired T790M mutation. However, patients receiving afatinib appeared to have longer mPFS than those on gefitinib or erlotinib. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|