Effect Of Common EGFR Mutant Genotype On Second - Line Treatment Strategy Of Advanced Lung Adenocarcinoma

Objective:To investigate the influences of the common mutation of EGFR(exon 19 deletion Vs. exon 21 substitution) to the clinical outcomes of the second-line chemotherapy or EGFR-TKI of advanced lung adenocarcinoma patients.Methods:128 patients’detail clinical information who received EGFR-TKI after first-line chemotherapy and 94 patients’information who received chemotherapy after first-line EGFR-TKI between April 1,2010 to December 31,2012, about age, gender, ECOG performance status (PS), clinical stage, smoking status, gross tumor type, EGFR-TKI drug information and genotypes of the EGFR mutations, were screened from the hospital information data base of the First and the Third Affiliated hospital of Kunming Medical University by the settings of inclusion criteria and exclusion criteria. The inclusion criteria include stage Ⅲb or Ⅳ lung adenocarcinoma,with mutant EGFR,received at least one cycle chemotherapy before EGFR-TKI or failed from EGFR-TKI before second-line chemotherapy,aged from 18 to 80,ECOG 0-2,life expectant more than 3 months. Then, a telephone follow-up and a review of all patients’image data of CT or MRI were done to obtain the survival information of all patients.After that, all patients’data were processed by IBM(?) SPSS(?) version 19.0.Results:When received second-line EGFR-TKI therapy after first-line chemotherapy,exon 19 deletion has a better survival than exon 21 substitution (Median PFS:8.1 Vs 6.8 months, P=0.002; Median OS:17.6 Vs 12.5 months,P=0.000).However,When received second-line chemotherapy after first-line EGFR-TKI,patients have the same survival outcomes(Median OS,8.2 Vs.8.6 months, P=0.865) and (Median PFS,4.1 Vs.4.2 months, P=0.837).Conclusion:When received second-line EGFR-TKI therapy after first-line chemotherapy,exon 19 deletion has a better survival than exon 21 substitution.However,When received second-line chemotherapy after first-line EGFR-TKI,patients have the same survival outcomes.