Articles Vol. 65 No. CĐ 3 - Bệnh viện Phổi Trung ương 15/05/2024

37. CLINICAL FEATURES, SUBCLINICAL CHARACTERISTICS AND RESULTS OF TARGET TREATMENT OF NON-SMALL CELL LUNG CANCER PATIENTS WITH DOUBLE MUTATIONS OF THE EGFR GENE PERIOD 2019-2023

Le Tu Linh1,2,3,4, Dinh Van Luong1,2,3,4, Le Van Quang2,4,5,6, Nguyen Hoang Anh2,4, Le Ngoc Minh Thu2,4, Hoang Huy Anh2,4, Nguyen Dieu My2,4, Nguyen Viet Nhung7,8, Nguyen Thi Trang2,4, Duong Huu Hieu1,3, Duong Danh Bo1,3
1 National Lung Hospital
2 Hanoi Medical University
3 Bệnh viện Phổi Trung ương
4 Đại học Y Hà Nội
5 K Hospital
6 i học Y dược-ĐH Quốc Gia Hà Nội - 144 Xuân Thủy, Cầu Giấy, Hà Nội, Việt Nam 4Bệnh viện K
7 University of Medicine and Pharmacy - Hanoi National University
8 Trường Đại học Y dược-ĐH Quốc Gia Hà Nội
Corresponding author: Trangnguyen@hmu.edu.vn
DOI: 10.52163/yhc.v65iCD3.1134
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Keywords
Epidermal growth factor receptor (EGFR), concomitant genes, treatment outcome.
Abstract

Background: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) administered as initial therapy enhance the quality of life for individuals diagnosed with EGFR mutation-sensitive non-small cell lung cancer (NSCLC). Our investigation focused on evaluating treatment outcomes among patients with EGFR-mutant NSCLC who exhibit concurrent gene alterations, aiming to ascertain their predictive significance regarding response to EGFR-TKIs treatment.

Materials and Methods: A retrospective cohort study was conducted the next gene sequencing (NGS) data from January 2019 to Jun 2023. All patients were categorized into two groups: One comprising individuals with a single EGFR mutation (group 1), and the other consisting of patients with concurrent EGFR mutations (group 2).

Results: 109 patients with EGFR mutation showed 72 patients had partial responses (66.1%), one had complete response (0.9%) and 17 patients had stable disease (15.6%); 19 patients had progressive disease (17.4%). The ORR was 67% and DCR was 82.6%. The PFS in the group with single EGFR mutation and concurrent gene alterations group were 15.03 months (CI 95%: 13.17-16.89) and 11.00 months (CI 95%: 9.95-12.05) (p= 0.001). Among the 43 patients with concomitant mutations, patients with ALK mutation had the longest PFS (13.43 months), followed by other PIK3CA (11.00 months) and the lowest PFS was MET application (4.77 months).

Conclusion: This study has demonstrated the concurrent gene alterations in some patients with EGFR mutations, which leads to reduced outcome of EGFR-TKIs. Patients carrying KRAS, BRAF, ROS1, or MET mutations are considered to have less predictive value for positive treatment outcomes.

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