Clinical Effects of T790M Mutation in EGFR Tyrosine Kinase Inhibitor Resistant NSCLC Patients

Overall survival was found to be 75 months and 27.5 months in the T790M positive and negative group, respectively, and this was statistically significant. (p: 0.009).

📌 3 Key Takeaways

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Objective & Hypothesis:INTRODUCTION: To compare patient characteristics between the T790M-positive and T790M-negative populations, and to analyze the post-progression survival (PPS) after initial tyrosine kinase inhibitor (TKI) failure in order to investigate the prognosis in patients undergoing rebiopsy.

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Key Findings & Data:METHODS: We investigated the patient characteristics, including the initial EGFR-TKI response and T790M status at the time of rebiopsy or liquid biopsy, subsequent treatment after resistance to the initial EGFR-TKI (the presence of EGFR-TKI re-challenge), treatment just before biopsy and/or rebiopsy (EGFR-TKIs or chemotherapy), the timing of the rebiopsy (just after the initial EGFR-TKI failure or others).

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Conclusion & Impact:Overall survival was found to be 75 months and 27.5 months in the T790M positive and negative group, respectively, and this was statistically significant. (p: 0.009).

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Domain Parameters

Abstract

INTRODUCTION: To compare patient characteristics between the T790M-positive and T790M-negative populations, and to analyze the post-progression survival (PPS) after initial tyrosine kinase inhibitor (TKI) failure in order to investigate the prognosis in patients undergoing rebiopsy. METHODS: We investigated the patient characteristics, including the initial EGFR-TKI response and T790M status at the time of rebiopsy or liquid biopsy, subsequent treatment after resistance to the initial EGFR-TKI (the presence of EGFR-TKI re-challenge), treatment just before biopsy and/or rebiopsy (EGFR-TKIs or chemotherapy), the timing of the rebiopsy (just after the initial EGFR-TKI failure or others). RESULTS: No difference was found between the two groups with T790M mutation positive and negative in terms of age, gender, and metastasis location. Only patients with positive T790M mutation had higher progression after TKI use compared to negative ones (p: 0.000). The progression-free median survival in patients using TKI was 19.33 months in the group with T790M mutation and 22.25 months in the negative group. Overall survival was found to be 75 months and 27.5 months in the T790M positive and negative group, respectively, and this was statistically significant. (p: 0.009). DISCUSSION AND CONCLUSION: Overall survival was significantly longer in the T790M positive group than in the T790M negative group. In addition, liquid biopsy can be performed several times for patients with progression after EGFR-TKI use and who do not want to undergo tissue biopsy

Özet

GİRİŞ ve AMAÇ: T790M - pozitif ve T790M - negatif popülasyonlar arasındaki hasta özellikleri karşılaştırıldı ve ilk tirozin kinaz inhibitörü (TKI) başarısızlığından sonra progresyon sonrası sağkalım (PPS) analiz edilerek yeniden biyopsi yapılan hastalarda prognoz araştırıldı. YÖNTEM ve GEREÇLER: Hastaların karakteristik özellikleri, EGFR-TKI yanıtı, rebiyopsi veya likit biyopsi sırasındaki EGFR durumu, rebiyopsi öncesi uygulanan tedavi (kemoterapi/ EGFR-TKI), ilk EGFR-TKI’a direnç geliştikten sonraki tedavi ve biyopsi zamanı (ilk EGFR-TKI başarısızlığı sonrası) araştırılmıştır. BULGULAR: T790M mutasyonu pozitif ve negatif olan iki grup arasında yaş, cinsiyet ve metastaz yeri arasında fark saptanmadı. Yalnızca T790M mutasyonu pozitif olan hastalarda TKİ kullanımı sonrası progresyonun negatif olanlara göre daha fazla olduğu görüldü (p: 0.001). TKİ kullanan hastalarda progresyonsuz median sağkalım T790M mutasyonu olan grupta 19,33 ay iken negative olan grupta 22.25 ay olarak saptandı. Genel sağkalım T790M pozitif ve negative olan grupta sırasıyla 75 ay ve 27,5 ay olarak bulundu ve bu istatistiksel olarak anlamlı idi (p: 0.009). TARTIŞMA ve SONUÇ: Genel sağkalım T790M pozitif grupta,T790M negatif gruba göre istatistiksel olarak anlamlı düzeyde uzun olarak saptandı. Ayrıca EGFR-TKI kullanımı sonrası progresyon olan ve doku biyopsisi yaptırmak istemeyen hastalara likit biyopsisinin birkaç kez yapılabilir.

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Cite This Article

ALICI, İ. O., ANAR, C., ERMİN, S., BATUM, Ö., KARADENİZ, G., BALCI, G., KÖMÜRCÜOĞLU, B., KUTBAY, Y., ERDOĞAN, K. M., POLAT, G., BÜYÜKŞİRİN, M., GAYAF, M., GÜLDAVAL, F., AYRANCI, A., ÜÇSULAR, F. D., TÜRK, M. A., ARIKAN, Ş., AKYOL, M. (2022). Clinical Effects of T790M Mutation in EGFR Tyrosine Kinase Inhibitor Resistant NSCLC Patients. Kocaeli Tıp Dergisi, Cilt: 10 - Sayı: 2, 51–56. https://ajindex.com/articles/574689

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