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J. Lu

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    Immunotherapy and next-generation TKIs: From second to frontline treatment (ID 55)

    • Event: ELCC 2018
    • Type: Poster Discussion session
    • Track:
    • Presentations: 1
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      140PD - Complex epidermal growth factor receptor (EGFR) mutations and responses to tyrosine kinase inhibitors (TKIs) in advanced lung adenocarcinomas (ID 411)

      07:45 - 09:00  |  Author(s): J. Lu

      • Abstract
      • Slides

      Two or more different epidermal growth factor receptor (EGFR) mutations can be detected within a single tumor sample, which represents complex mutations. However, the frequency and efficacy of tyrosine kinase inhibitor (TKI) treatments for patients harboring these mutations are unknown.

      From January 2011 to January 2017, patients diagnosed with EGFR mutation were screened. The effectiveness of TKIs in patients with complex mutations was retrospectively analyzed.

      A total of 16,840 subjects were screened, with 5898 positive patients. 187 patients (3.2% of all EGFR mutant patients) had complex EGFR mutations with 95 of advanced lung adenocarcinoma patients were treated with TKIs. The objective response rate (ORR) for patients who had Del-19 + 21L858R (Group A, n = 27), Del-19/21L858R + atypical mutations (Group B, n = 28), double atypical mutations (Group C, n = 20) and complex mutations with primary drug-resistant pattern (Group D, n = 20) were 72.7%, 54.2%, 66.7% and 15.0%, respectively. Median progression free survival (PFS) in the four groups were 18.2 months (95% CI, 12.0 months to 24.4 months), 10.1 months (95% CI, 6.5 months to 13.7 months), 11.1 months (95% CI, 6.8 months to 15.4 months) and 1.4 months (95% CI, 0.2 months to 2.5 months), respectively.

      These results suggest on the largest sample size that EGFR–TKI therapy is effective in patients with Del-19 + 21L858R, Del-19/21L858R + atypical mutations and double atypical mutations, but less effective in patients with primary drug–resistant pattern. Patients with the Del-19 + 21L858R mutations may therefore benefit more from treatment with first–generation TKIs.

      Clinical trial identification:

      Legal entity responsible for the study:
      Bo Zhang

      Has not received any funding

      All authors have declared no conflicts of interest.

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