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在用第三代EGFR-TKI治疗的非小细胞肺癌中,不常见的EGFR外19删除插入突变的预后影响

Renzhi Zhang¹, Huan Yan², Fang Tian²

¹Early Clinical Trial Center/Department of Medical Oncology, Lung Cancer and Gastrointestinal Unit, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan 410013, China; Department of Medical Oncology, Graduate Collaborative Training Base of Hunan Cancer Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China.

Lung cancer (Amsterdam, Netherlands)

|September 18, 2025

概括

患有EGFR 19delins高级非小细胞肺癌 (NSCLC) 的患者从第三代EGFR-TKI中获得的益处有限. 这种现实世界的证据表明,对于这个特定的突变子组,需要针对性治疗策略.

科学领域:

在瘤学瘤学.
遗传学是一个遗传学.
药理学药理学是指药理学的学科.

背景情况:

表皮生长因子受体 (EGFR) 突变是非小细胞肺癌 (NSCLC) 的关键驱动因素.
根据特定的EGFR突变配置文件,EGFR氨酸激酶抑制剂 (EGFR-TKI) 的疗效有所不同.
EGFR exon 19 删除插入 (19delins) 突变代表了一个独特的子组,具有潜在不同的治疗反应.

研究的目的:

评估患有EGFR 19delins突变的晚期NSCLC患者的生存结果,这些患者接受了第三代EGFR-TKI治疗.
为了比较EGFR 19delins患者的第一线和第二线第三代EGFR-TKI的疗效.
确定特定的19delins基因型及其与治疗反应的关联.

主要方法:

对215名EGFR19delins患者的临床,分子和生存数据的回顾性分析.
倾向性得分匹配用于在接受第一线 (n=57) 和第二线 (n=48) 第三代EGFR-TKI的患者之间比较无进展生存期 (PFS).
鉴定和描述各种EGFR 19delins基因型.

主要成果:

确定了39种独特的EGFR 19delins基因型,其中L747_P753delinsS,L747_A750delinsP和E746_S752delinsV是最常见的.
患有EGFR 19delins的患者在一线 (12.9 vs 19.7 个月) 和二线 (7.9 vs 10.5 个月) 设置中表现出明显较短的PFS中位数,相比于患有常见的外形19删除的患者.
探索性分析表明L747_P753delinsS可能与更差的预后有关,而E746_S752delinsV可能显示出更好的结果,需要进一步调查.

结论:

现实数据表明,与常见的EGFR 19del突变相比,第三代EGFR-TKIs对EGFR 19delinsNSCLC患者的临床益处有限.
这些发现凸显了对患有这种EGFR突变的患者进行优化治疗方案的需要.
需要进一步的研究来验证特定EGFR 19delins基因型的预后和预测价值.

关键词:

欧洲农业基金外区19删除-插入.非小细胞肺癌是非小细胞肺癌.精确瘤学是一门精确的专业.有针对性的治疗.第三代技术技术知识 (TKIs)

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