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Clinical implication and usefulness of de novo EGFR T790M mutation in lung adenocarcinoma with EGFR-tyrosine kinase inhibitor sensitizing mutation.

EGFR 酪氨酸激酶抑制剂敏感突变肺腺癌中 EGFR T790M 从头突变的临床意义和有用性。

  • 影响因子:3.07
  • DOI:10.1080/15384047.2020.1776579
  • 作者列表:"Lee SH","Kim EY","Kim A","Chang YS
  • 发表时间:2020-06-16
Abstract

:In total, 102 cases diagnosed as lung adenocarcinoma with EGFR-tyrosine kinase inhibitor (TKI) sensitizing mutations (mEGFR) and had been treated with 1st ~ 2nd generation EGFR-TKI alone were enrolled for this study. De novo T790 M status was tested using the tissues at the initial diagnosis and positivity was defined as the ratio of T790 M/wild-type copies over 0.00294 by ddPCR. :Seventy patients (68.6%) harbored the de novo T790 M. De novo T790 M was more frequently detected in cases with EGFR L858 R mutation than those with EGFR exon 19 deletion (E19d) mutations (P = 0.024). Forty-three patients underwent rebiopsy due to disease progression. The cases who experienced progression due to acquired T790 M were more likely to have E19d at initial diagnosis and the presence of de novo T790 M and the ratio of T790 M/wild-type copies did not relate to the emergence of acquired T790 M. On the other hand, the cases with a longer duration of disease-control by EGFR-TKI had higher change to get acquired T790 M mutation (P-value = 0.040). :The presence of de novo T790 M has limitation in predicting disease progression by acquired T790 M, suggesting that identifying de novo T790 M through the ultrasensitive methods may not be necessary identifying patients who would be beneficial by 3rd-generation EGFR-TKI as the 1st line treatment.

摘要

: 总共有 102 例诊断为肺腺癌的 EGFR 酪氨酸激酶抑制剂 (TKI) 敏感突变 (mEGFR) 本研究入组了单用第1 ~ 第2 代 EGFR-TKI 治疗的患者。初次诊断时使用组织检测从头 T790 M 状态,阳性定义为 ddPCR 检测 T790 M/野生型拷贝数超过 0.00294 的比率。 : 70 例患者 (68.6%) 窝藏从头 T790 M。De novo T790 M 在 EGFR l858r 突变的病例中比 EGFR 外显子 19 缺失 (E19d) 突变的病例中检测更频繁 (P = 0.024)。43 例患者因疾病进展行再次活检。由于获得性 T790 M 而经历进展的病例在最初诊断时更可能有 E19d,并且存在从头 T790 M 和 T790 M/野生型拷贝的比率没有。与后天 t790m 的出现有关。另一方面,EGFR-TKI 控制疾病时间较长的病例获得获得性 t790m 突变的变化较高 (P 值 = 0.040)。 : 从头 T790 M 的存在对获得性 T790 M 预测疾病进展有局限性,提示通过超灵敏的方法识别从头 T790 M 可能不是必要的,识别第3 代 EGFR-TKI 作为第1 线治疗有益的患者。

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DOI:10.1016/j.asjsur.2019.03.008
作者列表:["Esme H","Can A","Şehitogullari A"]

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影响因子:1.84
发表时间:2020-01-01
来源期刊:Oncology letters
DOI:10.3892/ol.2019.11149
作者列表:["Das SK","Huang YY","Li B","Yu XX","Xiao RH","Yang HF"]

METHODS::The aim of the present study was to compare the safety and efficacy of cryoablation (CA) and microwave ablation (MWA) as treatments for non-small cell lung cancer (NSCLC). Patients with stage IIIB or IV NSCLC treated with CA (n=45) or MWA (n=56) were enrolled in the present study. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall survival (OS) time and adverse events (AEs). The median PFS times between the two groups were not significantly different (P=0.36): CA, 10 months [95% confidence interval (CI), 7.5-12.4] vs. MWA, 11 months (95% CI, 9.5-12.4). The OS times between the two groups were also not significantly different (P=0.07): CA, 27.5 months (95% CI, 22.8-31.2 months) vs. MWA, 18 months (95% CI, 12.5-23.5). For larger tumors (>3 cm), patients treated with MWA had significantly longer median PFS (P=0.04; MWA, 10.5 months vs. CA, 7.0 months) and OS times (P=0.04; MWA, 24.5 months vs. CA, 14.5 months) compared patients treated with CA. However, for smaller tumors (≤3 cm), median PFS (P=0.79; MWA, 11.0 months vs. CA, 13.0 months) and OS times (P=0.39; MWA, 30.0 months vs. CA, 26.5 months) between the two groups did not differ significantly. The incidence rates of AEs were similar in the two groups (P>0.05). The number of applicators, tumor size and length of the lung traversed by applicators were associated with a higher risk of pneumothorax and intra-pulmonary hemorrhage in the two groups. Treatment with CA resulted in significantly less intraprocedural pain compared with treatment with MWA (P=0.001). Overall, the present study demonstrated that CA and MWA were comparably safe and effective procedures for the treatment of small tumors. However, treatment with MWA was superior compared with CA for the treatment of large tumors.

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影响因子:8.44
发表时间:2020-02-01
DOI:10.1016/j.annonc.2019.10.022
作者列表:["Mazieres J","Cropet C","Montané L","Barlesi F","Souquet PJ","Quantin X","Dubos-Arvis C","Otto J","Favier L","Avrillon V","Cadranel J","Moro-Sibilot D","Monnet I","Westeel V","Le Treut J","Brain E","Trédaniel J","Jaffro M","Collot S","Ferretti GR","Tiffon C","Mahier-Ait Oukhatar C","Blay JY"]

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