Genetic and treatment profiles of patients with concurrent Epidermal Growth Factor Receptor (EGFR) and Anaplastic Lymphoma Kinase (ALK) mutations

Autor: Rongrong Chen, Zhuo Yu, Xuefeng Xia, Jia Zhong, Xiaodan Yang, Minglei Zhuo, Jun Zhao, Min Zhang
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Cancer Research
Lung Neoplasms
ALK rearrangement
Antineoplastic Agents
medicine.disease_cause
Afatinib
Gefitinib
Non-small cell lung cancer
hemic and lymphatic diseases
Genetics
Confidence Intervals
Medicine
Anaplastic lymphoma kinase
Humans
Osimertinib
Anaplastic Lymphoma Kinase
Epidermal growth factor receptor
Progression-free survival
Lung cancer
Protein Kinase Inhibitors
Survival analysis
RC254-282
Aged
Retrospective Studies
Mutation
Acrylamides
Aniline Compounds
biology
business.industry
High-Throughput Nucleotide Sequencing
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Genes
erbB-1
Middle Aged
medicine.disease
Survival Analysis
Progression-Free Survival
respiratory tract diseases
Oncology
Drug Resistance
Neoplasm
Cancer research
biology.protein
EGFR mutation
business
medicine.drug
Research Article
Zdroj: BMC Cancer, Vol 21, Iss 1, Pp 1-8 (2021)
BMC Cancer
ISSN: 1471-2407
Popis: Background EGFR and ALK alternations often contribute to human malignancies, including lung cancer. EGFR and ALK mutations are usually sensitive to EGFR-tyrosine kinase inhibitors (TKIs) and ALK-TKIs. Although generally mutually exclusive, these mutations do co-exist in rare cases. This study investigated the frequencies, clinical characteristics, therapeutic efficacies, and genetic profiles of lung cancer patients with EGFR and ALK co-mutations. Methods Patients with concurrent EGFR and ALK mutations were included in this study, which analyzed mutation profiles and treatment histories. SPSS20.0 were used for survival analysis. Results Among 271 ALK-positive (ALK-pos) and 2975 EGFR-positive (EGFR-pos) patients in our database, nine (2.6% of ALK-pos and 0.2% of EGFR-pos) patients had concurrent EGFR and ALK mutations (including three exon19 Indel + EML4-ALK, two exon19 Indel + STRN-ALK, two L858R + L1152R, one L858R + EML4-ALK, and one G719C + S768I + STRN-ALK). Eight patients had at least one type of EGFR-TKIs treatment. The median progression free survival (PFS) of these patients on first-generation EGFR-TKIs was 14.5 months (95% CI: 11 - NR). Of these eight patients, one who progressed on Gefitinib and subsequently on Osimertinib had a T790M + C797G. The other seven EGFR-TKIs resistance patients had no known resistance mutations. No patients had ALK mutations before treatment, so ALK mutations may have developed as resistance mechanisms during EGFR-TKIs therapies. EGFR-TKIs-treated patients with EGFR/ALK L1152R mutations generally had a shorter PFS than patients with other mutation combinations. Conclusions ALK and EGFR mutations coincide at a relatively low frequency in lung cancer patients. ALK mutations developed either synchronously or heterochronously with EGFR mutations. Two ALK mutations (L1152R and STRN-ALK) may co-exist with EGFR mutations at a higher frequency than others. Most EGFR/ALK co-alteration patients (other than the EGFR/ALK L1152R type) can benefit from first line EGFR-TKIs.
Databáze: OpenAIRE
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