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Wei Y.,Shihezi University | Wei L.,Shihezi Municipal Peoples Hospital | Ma X.-P.,Shihezi University | Ma X.-Y.,Shihezi University | Gong P.,Shihezi University
Chinese Journal of Cancer Prevention and Treatment | Year: 2016

OBJECTIVE: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKI) have good therapeutic effects for EGFR mutations in non-small cell lung cancer, but approximately 50% of patients treated with EGFR-TKI occurred resistance mutations, that means T790M mutation. The present study was to investigate the relationship between EGFR gene in peripheral blood of advanced lung adenocarcinoma patients with exon 20 T790M mutation and acquired resistance to EGFR-TKI as well as the prognosis. METHODS: Totally 49 cases of EGFR-TKI resistance patients of advanced lung cancer were collected from 2013-12-08-2014-12-30 in Shihezi University School of Medicine, the First Affiliated Hospital. QIAamp Blood Mini Kit was used for serum free DNA test, Amplification Refractory Mutation System (ARMS) was used to detect peripheral blood plasma DNA in EGFR exon 20 T790M mutation and the clinical characteristics, efficacy and prognosis were analyzed. RESULTS: In 49 cases of patients with secondary resistance, T790M mutation was 30.6% (15/49). T790M mutation positive advanced NSCLC patients' age, sex, smoking, clinical stage, ECOG score, initial EGFR mutation type and EGFR-TKI types of drugs were unrelated, but EGFR-TKI resistance was related to disease progression, the difference was statistically significant (χ2=6.759, P=0.009). T790M mutation positive patients had prolonged PFS and OS compared with T790M mutation-negative patients (PFS, 9.6 months vs 6.8 months, χ2=2.057, P=0.018; OS, 17.6 months vs 12.7 months, χ2=2.851, P=0.027). Cox multivariate analysis showed that T790M mutations affected the PFS and OS independently (PFS, RR=0.653, 95% CI: 0.069-0.886, P=0.032; OS, RR=0.847, 95% CI: 0.208-2.696, P=0.008). CONCLUSIONS: T790M gene mutation is related to the type of disease progression in EGFR-TKI positive resistance patients and it is an independent factor for PFS and OS. © 2016, Editorial Board of Chinese Journal of Cancer Prevention and Treatment. All right reserved. Source

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