Yunha Nam1, Ho Cheol Kim1, Young-Chul Kim2, Seung Hun Jang3, Kye Young Lee4, Shin Yup Lee5, Sang Hoon Lee6, Sung Yong Lee7, Seong Hoon Yoon8, Jeong-Seon Ryu9, Tae Won Jang10, Yoon Soo Chang11, Seung Joon Kim12, Chan Kwon Park13, Jeong Eun Lee14, Chi Young Jung15, Chang-Min Choi1,16. 1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 2. Department of Internal Medicine, Chonnam National University Medical School, and Chonnam National University Hwasun Hospital, Hwasun, South Korea. 3. Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea. 4. Department of Pulmonary Medicine, Konkuk University School of Medicine, Seoul, South Korea. 5. Department of Internal Medicine, Kyungpook National University, School of Medicine, Daegu, South Korea. 6. Division of Pulmonology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 7. Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea. 8. Department of Pulmonology and Allergy, Pusan National University Yangsan Hospital, Yangsan, South Korea. 9. Department of Internal Medicine, Inha University Hospital, Incheon, South Korea. 10. Department of Internal Medicine, Kosin University Medical College, Pusan, South Korea. 11. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. 12. Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 13. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea. 14. Division of Pulmonology, Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, South Korea. 15. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, South Korea. 16. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND: In this study, we investigated the risk factors of acquired T790M mutation among patients with lung adenocarcinoma with epidermal growth factor receptor (EGFR) tyrosine mutation who were treated with EGFR-tyrosine kinase inhibitors (TKIs). The aim was to identify the clinical impact of rebiopsy. METHODS: This multicenter, retrospective cohort study was conducted in South Korea from January 2007 to June 2017. Patients with adenocarcinoma with EGFR mutation who underwent rebiopsy and were treated with EGFR-TKIs were included. RESULTS: Of a total of 352 patients, T790M mutation was identified in 156 (41.9%) at the time of rebiopsy. The median duration from initial biopsy to rebiopsy was 17 months. Univariate logistic regression analysis revealed associations of exon 19 deletion (odds ratio [OR], 1.643; p = 0.026), absence of L858R (OR, 0.627; p = 0.042), and previous EGFR-TKI treatment duration (OR, 1.039; p < 0.001) with T790M mutation. Previous EGFR-TKI treatment duration (OR, 3.580; p < 0.001) was independently associated with T790M mutation. A multivariate Cox proportional hazard model revealed that brain metastasis at initial diagnosis (hazard ratio, 1.390; p = 0.050) tended to be associated with T790M mutation. Among the patients with T790M mutation at rebiopsy, the osimertinib user group (n = 90) had a better one-year survival (68.7 vs. 58.3%, p = 0.048) than the osimertinib nonuser group (n = 66). CONCLUSIONS: Rebiopsy might affect the clinical course of patients with EGFR-mutant adenocarcinoma who receive EGFR-TKIs.
BACKGROUND: In this study, we investigated the risk factors of acquired T790M mutation among patients with lung adenocarcinoma with epidermal growth factor receptor (EGFR) tyrosine mutation who were treated with EGFR-tyrosine kinase inhibitors (TKIs). The aim was to identify the clinical impact of rebiopsy. METHODS: This multicenter, retrospective cohort study was conducted in South Korea from January 2007 to June 2017. Patients with adenocarcinoma with EGFR mutation who underwent rebiopsy and were treated with EGFR-TKIs were included. RESULTS: Of a total of 352 patients, T790M mutation was identified in 156 (41.9%) at the time of rebiopsy. The median duration from initial biopsy to rebiopsy was 17 months. Univariate logistic regression analysis revealed associations of exon 19 deletion (odds ratio [OR], 1.643; p = 0.026), absence of L858R (OR, 0.627; p = 0.042), and previous EGFR-TKI treatment duration (OR, 1.039; p < 0.001) with T790M mutation. Previous EGFR-TKI treatment duration (OR, 3.580; p < 0.001) was independently associated with T790M mutation. A multivariate Cox proportional hazard model revealed that brain metastasis at initial diagnosis (hazard ratio, 1.390; p = 0.050) tended to be associated with T790M mutation. Among the patients with T790M mutation at rebiopsy, the osimertinib user group (n = 90) had a better one-year survival (68.7 vs. 58.3%, p = 0.048) than the osimertinib nonuser group (n = 66). CONCLUSIONS: Rebiopsy might affect the clinical course of patients with EGFR-mutant adenocarcinoma who receive EGFR-TKIs.
Authors: Geoffrey R Oxnard; Maria E Arcila; Camelia S Sima; Gregory J Riely; Juliann Chmielecki; Mark G Kris; William Pao; Marc Ladanyi; Vincent A Miller Journal: Clin Cancer Res Date: 2010-12-06 Impact factor: 12.531
Authors: Lecia V Sequist; Belinda A Waltman; Dora Dias-Santagata; Subba Digumarthy; Alexa B Turke; Panos Fidias; Kristin Bergethon; Alice T Shaw; Scott Gettinger; Arjola K Cosper; Sara Akhavanfard; Rebecca S Heist; Jennifer Temel; James G Christensen; John C Wain; Thomas J Lynch; Kathy Vernovsky; Eugene J Mark; Michael Lanuti; A John Iafrate; Mari Mino-Kenudson; Jeffrey A Engelman Journal: Sci Transl Med Date: 2011-03-23 Impact factor: 17.956
Authors: Helena A Yu; Maria E Arcila; Natasha Rekhtman; Camelia S Sima; Maureen F Zakowski; William Pao; Mark G Kris; Vincent A Miller; Marc Ladanyi; Gregory J Riely Journal: Clin Cancer Res Date: 2013-03-07 Impact factor: 12.531