Correlation Between EGFR Mutation Site And Abundance And Efficacy Of Targeted Drugs In Patients With Lung Adenocarcinoma

Objective: To explore the relationship between EGFR mutation sites,abundance and curative effect in patients with lung adenocarcinoma.Methods: A total of 473 patients who purchased first-generation targeted drugs in the outpatient department of the Fourth Hospital of Hebei Medical University from September 2018 to September 2019 were statistically analyzed.EGFR mutation status of lung adenocarcinoma patients was detected by PCR or NGS method,and then the efficacy of targeted drugs was determined by RECIS1.1standard.ROC curve analysis was carried out to explore the optimal cutoff value of high and low mutation abundance,and the correlation among mutation sites,high and low mutation abundance and efficacy was analyzed.Results:1.The median PFS of the 24 patients was 9.8 months,ORR was25.0% and DCR was 100%.2.In this group of data studies,gender,smoking history,clinical stage,presence of brain metastasis,gene mutation site and nature of gene test samples had no effect on gene mutation abundance of patients(P>0.05).3.The mutation abundance of tissue specimens and serosal cavity effusion specimens was higher,while that of plasma specimens was lower,with the median mutation abundance being 35.75%,31.87%,and12.61%,respectively.Serosal cavity effusion specimens may be a substitute for tissue specimens,However,this result needs to be further verified.4.After disease progression,the median PFS was longer in patients with mutation site changes(combined/converted to other mutation sites) than in patients with in-situ mutation,with statistically significant differences(12.1 months vs6.7 months,P=0.013).5.The PFS of the high-abundance group was longer than that of the low-abundance group,but the results were not statistically significant(10.2 months vs.9.4 months,P=0.958).6.Among the 8 patients treated with oral amitinib,4 patients had mild adverse reactions and improved spontaneously without treatment,while 4 patients had no obvious adverse reactions and no serious adverse reactions.Conclusions:1.Changes in gene mutation sites after targeted therapy may indicate better efficacy,but the relationship between gene mutation abundance and efficacy remains unclear.2.The safety of Almonertinib is good,and the effect of first-line oral administration of amitinib in patients with L858R mutation remains to be observed.