Aggressive progression to EGFR tyrosine kinase inhibitors in advanced NSCLC patients: concomitant mutations, prognostic indicator and subsequent management

Autor: Ruishan Wen, Ying Chen, Jinyu Long, Xiulian Huang, Yuxin Guo, Baoquan Lin, Zongyang Yu
Rok vydání: 2023
Předmět:
Zdroj: Journal of Cancer Research and Clinical Oncology.
ISSN: 1432-1335
0171-5216
DOI: 10.1007/s00432-023-04757-4
Popis: Background EGFR tyrosine kinase (TKIs) are recommend as the first-line treatment for non-small cell lung cancer (NSCLC) patients with EGFR mutation. However, some patients experience aggressive progression with a progression-free survival (PFS) less than 6 months on the first-line EGFR TKI therapy. Therefore, our study is to analyze the potential influencing factors including clinical features, biomarkers, concomitant mutations et al. Methods A total of 1073 NSCLC patients with EGFR mutation in a multi-center study from January 2019 to December 2021. The datum pathological and molecular characteristics were collected. The area under the receiver operating characteristic (ROC) curve was used to evaluate the predictive effect of Ki-67 on the first-line TKI. The curve of PFS was conducted by Kaplan–Meier method and tested by bilateral log-rank. Cox regression model was used to predict and evaluate PFS of different variables. Chi-square or Fisher analysis was used for correlation between groups. Results 55 patients who show aggressive progression (PFS ≤ 6 months) on the first-line TKI therapy were analyzed in this study, while 71 with slow progression (PFS > 6 months). Concomitant mutations including AXIN2, P2CG and RAD51C mutations occurred only in the aggressively progressive group (P = 0.029). Correlation between Ki-67 index and the aggressive progression of the first-line TKI therapy was significant statistically different (P Conclusion NSCLC harbored EGFR and concomitant mutations (such as AXIN2, PLCG2 and RAD51C), and/or Ki-67 high expression may indicate the aggressive progression to the first-line EGFR-TKI.
Databáze: OpenAIRE
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