264例肺腺癌患者EGFR基因突变及TKI类药物临床疗效分析.docVIP

264例肺腺癌患者EGFR基因突变及TKI类药物临床疗效分析 刘 冰1，，Analysis of 264 cases of lung adenocarcinoma patients with EGFR gene mutations and clinical efficacy of TKI drugs LIU Bing1, LIU Yi2，TANG Chuanhao1，LI Xiaoyan1， LIU Xue3， （1．Department of Lung Cancer, Affiliated Hospital, Academy of Military Medical Sciences，Beijing 100071，China；2.Tumor Molecular Biology Laboratory，Affiliated Hospital, Academy of Military Medical Sciences，Beijing 100071，China；3. Health Centers, The General Logistics Department of Military Traffic Institute of Transportation, Tianjin 300161，China） Corresponding author:liu bing，TELE-mail liubing307@163.com [Abstract]Objective：To analysis the mutation rate of epidermal growth factor receptor (EGFR) exon 19 and 21 in lung adenocarcinoma patients, as well as their response to tyrosine kinase inhibitors (TKI). Method: 264 lung adenocarcinoma patients with tissue or body fluids samples from 2011-2013 in our department were enrolled in this study. The EGFR mutation of exon 19 and 21 were detected by direct sequencing. The TKI outcomes of these patients were analyzed retrospectively.Results: 27.3% (72/264) of the patients were detected with 19 del or L858R mutation, and the mutation rate for 19del and L858R was 15.1% 12.1% respectively. In addition, several rare mutation such as P753L in exon 19 and L861Q, L861P in exon 21 were also been found. The toxicity and the intolerance of TKI therapy were good, and for the patients with this treatment, the disease control rate (DCR) of EGFR mutation positive patients was found obviously better than negative ones (87% vs 50.8%, P0.01), and the DCR of patients with 19 del was also found higher than patients with L858R (94.4% vs 60%, P0.01). Conclusions: Patient with EGFR mutation account approximately for one third of lung adenocarcinoma. 19 del and L858R were the most frequently seen mutation, and patients with this kind of mutation response well with TKI therapy, especially for 19 del. In order to maximized the bene