Value of detection of peripheral blood epidermal growth factor receptor gene mutation in predicting the therapeutic efficacy of non-small cell lung cancer

Abstract

Objective To investigate the value of detecting peripheral blood epidermal growth factor receptor (EGFR) gene in predicting the therapeutic efficacy of advanced non-small cell lung cancer. Methods A total of 150 patients with stage ⅢA-Ⅳ non-small cell lung cancer diagnosed in Shanxi Provincial Cancer Hospital from October 2013 to February 2015 were collected. The peripheral blood EGFR gene was detected by amplification refractory mutation system (ARMS). The relationship between the mutation rate and the clinicopathological features of patients was observed, and 80 patients were selected into the follow-up treatment according to the inclusion criteria. Forty patients (all 19 or 21 exon mutations) in group A with EGFR gene mutation were treated with gefitinib orally. Forty patients with wild type EGFR gene in group B underwent 4 cycles of NP regimen. Efficacy and progression-free survival were evaluated in both groups. Results The mutation rate of EGFR gene was 33.3% (50 cases), of which 29 were exon 19, 18 were exon 21 and 3 were exon 18 and 20. The mutation rate of EGFR gene was higher in female, adenocarcinoma and non-smoker (all P < 0.05). Among the 80 patients who received follow-up treatment, the effective rate [67.5% (27/40) vs. 32.5% (13/40)] and disease control rate [85.0% (34/40) vs. 65.0% (26/40)] in group A were significantly higher than those in group B, and the median PFS was prolonged (9.00 months vs. 4.25 months), the differences were statistically significant (χ2= 9.800, P= 0.002; χ2= 4.267, P= 0.039; χ2= 15.792, P < 0.001). Conclusion The detection of peripheral blood EGFR mutation can be used to predict the efficacy of tyrosine kinase inhibitors in non-small cell lung cancer. Key words: Carcinoma, non-small-cell lung; Receptor, epidermal growth factor; Gene mutation; Tyrosine kinase inhibitor