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Screening for Epidermal Growth Factor Receptor Mutations in Lung Cancer

热1 peacock 添加于 2009-8-25 09:15 | 2966 次阅读 | 1 个评论

作者
Rosell R, Moran T, Queralt C, Porta R, Cardenal F, Camps C, Majem M, Lopez-Vivanco G, Isla D, Provencio M, Insa A, Massuti B, Gonzalez-Larriba JL, Paz-Ares L, Bover I, Garcia-Campelo R, Moreno MA, Catot S, Rolfo C, Reguart N, Palmero R, Sanchez JM, Bastus R, Mayo C, Bertran-Alam
摘要
BACKGROUND: Activating mutations in the epidermal growth factor receptor gene (EGFR) confer hypersensitivity to the tyrosine kinase inhibitors gefitinib and erlotinib in patients with advanced non-small-cell lung cancer. We evaluated the feasibility of large-scale screening for EGFR mutations in such patients and analyzed the association between the mutations and the outcome of erlotinib treatment. METHODS: From April 2005 through November 2008, lung cancers from 2105 patients in 129 institutions in Spain were screened for EGFR mutations. The analysis was performed in a central laboratory. Patients with tumors carrying EGFR mutations were eligible for erlotinib treatment. RESULTS: EGFR mutations were found in 350 of 2105 patients (16.6%). Mutations were more frequent in women (69.7%), in patients who had never smoked (66.6%), and in those with adenocarcinomas (80.9%) (P<0.001 for all comparisons). The mutations were deletions in exon 19 (62.2%) and L858R (37.8%). Median progression-free survival and overall survival for 217 patients who received erlotinib were 14 months and 27 months, respectively. The adjusted hazard ratios for the duration of progression-free survival were 2.94 for men (P<0.001); 1.92 for the presence of the L858R mutation, as compared with a deletion in exon 19 (P=0.02); and 1.68 for the presence of the L858R mutation in paired serum DNA, as compared with the absence of the mutation (P=0.02). The most common adverse events were mild rashes and diarrhea; grade 3 cutaneous toxic effects were recorded in 16 patients (7.4%) and grade 3 diarrhea in 8 patients (3.7%). CONCLUSIONS: Large-scale screening of patients with lung cancer for EGFR mutations is feasible and can have a role in decisions about treatment. Copyright 2009 Massachusetts Medical Society.
详细资料
- 文献种类:期刊
- 期刊名称: The New England Journal of Medicine
- 期刊缩写: N Engl J Med
- 期卷页: 2009年
- 地址: The authors' affiliations and the names of additional investigators are listed in the Appendix. This article (10.1056/NEJMoa0904554) was published on August 19, 2009, at NEJM.org
- ISBN: 1533-4406
- 备注:PMID:19692684
标签

化疗药非小细胞肺癌突变表皮生长因子受体 EGFR
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附件
Screening for Epidermal Growth Factor Receptor Mutations in Lung Cancer
peacock 的文献笔记订阅

EGRF突变可增加化疗药物疗效。

针对性用药很关键