Effect of epidermal growth factor receptor gene mutation on clinical pathology and clinical effect of tyrosine kinase inhibitor in non-small cell lung cancer

LI Xiaofeng; WANG Yuanyuan; LIU Xi

doi:10.3969/j.issn.1006-5725.2019.04.006

Abstract：Objective To explore the effect of epidermal growth factor receptor (EGFR) gene mutation on clinical pathology of non-small cell lung cancer (NSCLC) and clinical efficacy of tyrosine kinase inhibitor (TKI) treatment. Methods 460 NSCLC patients who were treated in our hospital from January 2017 to December 2017 were selected in this study. Based on types of mutations, they were divided into mutant positive group (129 cases) and mutant negative group (331 cases). The mutant positive group was further divided into TKI target treatment group (72 cases) and chemotherapy group (57 cases). All patients in the mutant negative group received chemotherapy (331 cases) treatment. Finally, the relationship between the EGFR gene mutation and clinical pathology was analyzed, and the progression-free survival (PFS) among groups of TKI therapy, chemotherapy of mutant positive group and chemotherapy of mutant negative group was compared. Results (1) It was found that the mutation of EGFR gene in NSCLC patients was closely related to the sex, smoking, pathological type, degree of differentiation, and serum carcinoembryonic antigen (CEA) level (P < 0.05). (2) The ORR and DCR in patients treated with TKI were significantly higher than those in other patients with positive gene mutation (P < 0.05). (3) The ORR and DCR in the EGFR mutant negative group were significantly higher than those in the EGFR mutant positive group (P < 0.05). (4) The PFS were significantly different among all groups (P<0.05) : (201.65±20.81) d in TKI group; (116.53 ± 11.61) d in chemotherapy of mutant positive group and (167.59 ± 11.46) d in mutant negative group. Conclusions The mutation of EGFR gene in NSCLC patients occurs more frequently in women, nonsmokers, adenocarcinoma, and those whose serum CEA ≥ 5 ng/mL.TKI therapy can effectively prolong the PFS in patients with EGFR positive mutation. However, it's more effective to use chemotherapy for patients without EGFR positive mutation.