Abstract
Background Great success has been made in the targeting therapy of advanced non-small cell lung cancer (NSCLC). Nowadays, next generation sequencing (NGS) is acquirable and affordable in developed area of China. Using this feasible and accurate method of detecting therapeutic genes would help to select optimal treatments to extend patients survival. Here, we identified somatic mutations by NGS and analyzed the value for treatment of NSCLC in a real-world clinical setting. Methods NGS was carried out on biopsy samples obtained from 66 advanced unresectable NSCLC patients who had not received any treatment. 23 patients received liquid biopsy after failure of first-line targeted treatment. The mutation profiling as well as associations between mutations and clinicopathological characters was analyzed. The study also assessed the values of NGS for choosing treatment options and predicting prognosis in NSCLC patients. Results 152 somatic mutations were identified in 45 (68.18%) tissue samples. The most frequently mutated genes were EGFR (42.42%), TP53 (31.82%) and KRAS (15.15%). Specifically, the most frequent EGFR (42.42%), EGFR (42.42%), p = 0.046). In addition, in the smoking group, patients with EGFR (42.42%), p = 0.046). In addition, in the smoking group, patients with EGFR (42.42%), EGFR (42.42%), p = 0.046). In addition, in the smoking group, patients with Conclusions The observational study from real-world demonstrated that using NGS in routine clinical detection may be useful in guiding the therapy decisions and benefit more Chinese NSCLC patients.
Highlights
Non-small cell lung cancer (NSCLC) contributes to over 80% of all lung cancer cases and it is one of the leading causes of cancer-related deaths worldwide [1]
Possible mechanisms for the acquired resistance may be the appearance of second-site hot spot mutations [8]. e most common and famous alteration is Epidermal growth factor receptor (EGFR) T790M mutation. e efficiency of the third-generation EGFR-tyrosine kinase inhibitors (TKI) osimertinib in treating EGFR T790M mutated patients has been demonstrated in several studies [9,10,11]
Tissues were obtained by transbronchoscopic lung biopsy, lymph node biopsy, thoracentesis or lumbar puncture. e personal data of each participant about clinical characteristics and survival information was collected from clinical record or family contact. e overall survival (OS) was defined as time from the data of diagnosis to the data of death or last visit. e progression-free survival (PFS) was calculated from the time of diagnosis to the time of progression, relapse, death, or the last follow-up. is prospective observational study was reviewed by our institutional review board and written informed consent was provided by each patient
Summary
Non-small cell lung cancer (NSCLC) contributes to over 80% of all lung cancer cases and it is one of the leading causes of cancer-related deaths worldwide [1]. It is well known that NSCLC patients with the EGFR exon 19 deletion or L858R mutation show initial responses to first-generation of TKI, such as gefitinib and erlotinib. Generation sequencing (NGS) is acquirable and affordable in developed area of China Using this feasible and accurate method of detecting therapeutic genes would help to select optimal treatments to extend patients survival. We identified somatic mutations by NGS and analyzed the value for treatment of NSCLC in a real-world clinical setting. Patients with EGFR exon 19 deletion mutation have longer overall survival (OS) than the wide-type (36.0 months versus 19.0 months 푝 = 0.046). A er the failure of first-line targeted therapy, 23 EGFR mutated patients received liquid biopsy, and the positive rate of T790M mutation in EGFR exon 20 was 47.83%. Conclusions. e observational study from real-world demonstrated that using NGS in routine clinical detection may be useful in guiding the therapy decisions and benefit more Chinese NSCLC patients
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