Correlation Analysis between T790M Status and Clinical Characteristics of Patients with EGFR-sensitive Mutation Advanced NSCLC who Progressed after the First Generation and First-line EGFR-TKIs Administration: A Real-world Exploratory Study


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Abstract

Aims:The present study is to investigate the association between T790M status and clinical characteristics of patients with EGFR-sensitive advanced non-small cell lung cancer (NSCLC) who progressed the initial epidermal growth factor receptor tyrosine kinase inhibitors (EGFRTKIs) administration.

Methods:A total of 167 patients with EGFR-sensitive mutations advanced NSCLC who had successful genetic tests and progressed the initial EGFR-TKI treatment were included in this study retrospectively. The clinical and demographic characteristics of these patients were collected, which were manifested as pathological type, metastasis location, initial biopsy method, initial genetic test specimens, and baseline gene mutations status. Correlation analysis between T790M status and these characteristics was performed and prognostic analysis regarding the different subgroups was carried out accordingly.

Results:The prevalence of secondary T790M after resistance to initial EGFR-TKIs among the 167 patients was 52.7%. Correlation analysis indicated that the median progression-free Survival (PFS) to initial EGFR-TKIs >12 months were more likely to develop secondary T790M in univariate analysis. However, the conclusion failed to show statistically significant in multivariate analysis. Additionally, patients with intracranial progression of initial EGFR-TKIs therapy were associated with secondary EGFR-T790M. However, it should be noted that those whose best overall response was partial response (PR) during the EGFR-TKI therapy were relevant to secondary T790M. Furthermore, The median PFS of the initial EGFR-TKIs administration was longer among patients with T790M positive mutation and patients with PR reaction than those without T790M mutation and patients with stable disease (SD), respectively (median PFS: 13.6 vs. 10.9 months, P=0.023) and (median PFS: 14.0 vs. 10.1 months, P=0.001).

Conclusion:This retrospective study highlighted the real-world evidence that the best efficacy and intracranial progression with initial EGFR-TKIs therapy among patients with advanced NSCLC might be the promising indicators to predict the occurrence of EGFR-T790M. Patients with PR reaction and T790M positive mutation conferred longer PFS of the initial EGFR-TKIs administration. Also, the conclusion should be confirmed in more patients with advanced NSCLC subsequently.

About the authors

Ye Zhen

Department of Medical Oncology, The First Affiliated Hospital of Xingtai Medical College

Email: info@benthamscience.net

Ying-Bo Xu

Department of Medical Oncology, The First Affiliated Hospital of Xingtai Medical College

Email: info@benthamscience.net

Ruo-Ying Deng

Department of Medical Oncology, Fourth Hospital of Hebei Medical University

Email: info@benthamscience.net

Meng Li

Department of Medical Oncology, Quyang Cancer Hospital/Hengzhou Hospital

Email: info@benthamscience.net

Min-Ting Ma

Department of Medical Oncology, Fourth Hospital of Hebei Medical University

Email: info@benthamscience.net

Zhi-Guo Zhou

Department of Medical Oncology, Fourth Hospital of Hebei Medical University

Email: info@benthamscience.net

Qing-Ju Meng

Department of Orthopedics, The First Affiliated Hospital of Xingtai Medical College

Author for correspondence.
Email: info@benthamscience.net

Ya-Ning Gong

Department of Medical Oncology, the First Hospital of Xingtai

Email: info@benthamscience.net

Li-Yan Zhao

Department of Medical Oncology, The First Affiliated Hospital of Xingtai Medical College

Email: info@benthamscience.net

Yi-Bing Liu

Department of Medical Oncology, Fourth Hospital of Hebei Medical University

Author for correspondence.
Email: info@benthamscience.net

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