Open Access

Predictive value of tumor genetic alteration profiling for chemotherapy and EGFR‑TKI treatment in advanced NSCLC

  • Authors:
    • Wei Jiang
    • Aiping Zeng
    • Ruiling Ning
    • Wenhua Zhao
    • Cuiyun Su
    • Huilin Wang
    • Shaozhang Zhou
    • Qitao Yu
  • View Affiliations

  • Published online on: April 1, 2020     https://doi.org/10.3892/ol.2020.11502
  • Pages: 3859-3870
  • Copyright: © Jiang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Previous studies have suggested that a variety of tumor driver genetic alterations affected the treatment efficacy of chemotherapy and epidermal growth factor receptor (EGFR)‑tyrosine kinase inhibitors (TKIs) in advanced non‑small cell lung cancer (NSCLC). The present study aimed to investigate the association between the tumor genetic alteration landscape and the treatment outcome of first‑line chemotherapy and EGFR‑TKIs in advanced NSCLC. A total of 94 patients with advanced NSCLC were recruited. All patients received first‑line chemotherapy and/or EGFR‑TKIs (either first‑ or second‑generation EGFR‑TKI, or third‑generation EGFR‑TKI) alone or sequentially. Prior to chemotherapy and/or EGFR‑TKI treatment, plasma, effusion and/or tumor tissues from the included patients were subjected to next‑generation sequencing, targeting 59 genes. The results indicated that the positive genetic alteration status prior to first‑line chemotherapy was associated with prolonged progression‑free survival (PFS) time compared with the negative status [9.1 vs. 4.0 months; hazard ratio (HR)=6.68; 95% CI, 2.25‑19.82; P=0.001). Furthermore, patients with EGFR activating mutation harboring concomitant alterations exhibited a shorter PFS (11.1 vs. 7.4 months; HR=2.14; 95% CI, 1.03‑4.44; P=0.04) and overall survival (OS) time [not reached (NR) vs. 32.8 months; HR=4.30; 95% CI, 1.41‑13.16; P=0.01] than those without concomitant alterations, with first‑ and second‑generation EGFR‑TKI treatment. Similarly, patients with T79M mutation harboring concomitant alterations exhibited a shorter PFS (15.6 vs. 3.6 months; HR=9.48; 95% CI, 2.29‑39.28; P=0.002) and OS time (NR vs. 32.8 months; HR=4.85; 95% CI, 1.16‑20.29; P=0.03) with osimertinib treatment. Taken together, the results demonstrated that positive genetic alteration status predicted greater efficacy of first‑line chemotherapy, while concomitant genetic alterations were associated with poor treatment outcome for first‑ or second‑generation EGFR‑TKI and third‑generation EGFR‑TKI treatment.
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June-2020
Volume 19 Issue 6

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Spandidos Publications style
Jiang W, Zeng A, Ning R, Zhao W, Su C, Wang H, Zhou S and Yu Q: Predictive value of tumor genetic alteration profiling for chemotherapy and EGFR‑TKI treatment in advanced NSCLC. Oncol Lett 19: 3859-3870, 2020
APA
Jiang, W., Zeng, A., Ning, R., Zhao, W., Su, C., Wang, H. ... Yu, Q. (2020). Predictive value of tumor genetic alteration profiling for chemotherapy and EGFR‑TKI treatment in advanced NSCLC. Oncology Letters, 19, 3859-3870. https://doi.org/10.3892/ol.2020.11502
MLA
Jiang, W., Zeng, A., Ning, R., Zhao, W., Su, C., Wang, H., Zhou, S., Yu, Q."Predictive value of tumor genetic alteration profiling for chemotherapy and EGFR‑TKI treatment in advanced NSCLC". Oncology Letters 19.6 (2020): 3859-3870.
Chicago
Jiang, W., Zeng, A., Ning, R., Zhao, W., Su, C., Wang, H., Zhou, S., Yu, Q."Predictive value of tumor genetic alteration profiling for chemotherapy and EGFR‑TKI treatment in advanced NSCLC". Oncology Letters 19, no. 6 (2020): 3859-3870. https://doi.org/10.3892/ol.2020.11502