Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor Treatment Response in Advanced Lung Adenocarcinomas with G719X/L861Q/S768I Mutations
Open accessAbstract
Background Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is the standard therapy for advanced lung adenocarcinomas with common EGFR mutations. Preclinical studies have suggested that uncommon G719X, L861Q, and S768I mutations are also sensitive to EGFR-TKIs. However, the efficacy of EGFR-TKIs in patients with these uncommon mutations remains unclear.Methods A nationwide survey was performed to collect data from gefitinib and erlotinib treatment outcomes of patients with stage IIIB/IV lung adenocarcinoma bearing EGFR G719X/L861Q/S768I mutations. The results were compared with those regarding patients with exon 19 deletions or L858R mutations.Results One hundred and sixty-one patients with uncommon EGFR mutations were enrolled from 18 institutes throughout Taiwan. Mutations of G719X, L861Q, S768I, G719X + L861Q, and G719X + S768I were observed in 78, 57, 7, 9, and 10 patients, respectively. After receiving EGFR-TKI treatment, patients with uncommon mutations exhibited a significantly inferior tumor response rate (41.6% vs. 66.5%; p < 0.001) and progression-free survival (median, 7.7 vs. 11.4 months; p < 0.001) than patients with common mutations. Among the patients who used EGFR-TKIs as first-line treatment, there was a significant difference in overall survival between these two groups of patients (median, 24.0 vs. 29.7 months; p = 0.005).Conclusion Gefitinib and erlotinib are active in patients with G719X/L861Q/S768I mutations; however, less effective than in those with common mutations.
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Patients with compound mutations are associated with improved outcomes among those harboring rare mutations.
“Patients with compound mutations are associated with improved outcomes among those harboring rare mutations [19,20,48,89], although a high level of heterogeneity exists.”
Chiu et al reported an ORR of only 33.3% with first-generation EGFR TKI in patients with only the S768I mutation.
“Chiu et al 32 reported an ORR of only 33.3% with fi rst-generation EGFR TKI in patients with only the S768I mutation.”
From Osimertinib for Patients With Non–Small-Cell Lung Cancer Harboring Uncommon EGFR Mutations: A Multicenter, Open-Label, Phase II Trial (KCSG-LU15-09) (2020) · cites this paper as [32]
Several studies have shown that 1G EGFR-TKI are less effective in patients with NSCLC harboring uncommon EGFR mutations compared with patients harboring common EGFR mutations.
“Several studies, although very small, have shown that 1G EGFR‐TKI are less effective in patients with NSCLC harboring such uncommon EGFR mutations, compared with patients harboring common EGFR mutations.”
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- Authors
- Chiu, C.-H., Yang, C.-T., Shih, J.-Y., Huang, M.-S., Su, W.-C., Lai, R.-S., Wang, C.-C., Hsiao, S.-H., Lin, Y.-C., Ho, C.-L., Hsia, T.-C., Wu, M.-F., Lai, C.-L., Lee, K.-Y., Lin, C.-B., Yu-Wung Yeh, D., Chuang, C.-Y., Chang, F.-K., Tsai, C.-M., Perng, R.-P., & Chih-Hsin Yang, J.
- Affiliations
- Taipei Veterans General Hospital (TW)
- Chang Gung University (TW)
- National Taiwan University (TW)
- Kaohsiung Medical University (TW)
- National Cheng Kung University Hospital (TW)
- Kaohsiung Veterans General Hospital (TW)
- Kaohsiung Chang Gung Memorial Hospital (TW)
- Taipei Medical University Hospital (TW)
- Tri-Service General Hospital (TW)
- China Medical University (TW)
- Chung Shan Medical University Hospital (TW)
- Tzu Chi University (TW)
- Taipei Medical University-Shuang Ho Hospital (TW)
- Taipei City Hospital (TW)
- Corresponding author
- Chiu, Chao-Hua
- ORCID
- Venue
- Journal of Thoracic Oncology
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 10
- Issue
- 5
- Pages
- 793-799
- ISSN
- 1556-0864 (ISSN-L)
- OpenAlex
- W2062629045
- Cited by
- 241
- References
- 25
- Citations by year
- 2026: 6 · 2025: 8 · 2024: 29 · 2023: 21 · 2022: 34 · 2021: 22 · 2020: 30 · 2019: 27 · 2018: 16 · 2017: 28 · 2016: 14 · 2015: 5
- FWCI
- 16.61
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Thoracic Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- EGFR tyrosine kinase inhibitors, advanced lung adenocarcinoma, G719X mutation, L861Q mutation, gefitinib, erlotinib, treatment response, progression-free survival, overall survival, exon 19 deletion, L858R mutation, uncommon EGFR mutations
- MeSH terms
- Erlotinib Hydrochloride, Gefitinib, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Female, Humans, Lung Neoplasms, Male, Middle Aged, Mutation, Quinazolines, Survival Rate, Treatment Outcome, Disease-Free Survival, Protein Kinase Inhibitors, ErbB Receptors
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