Analysis Of Clinicopathological Features Of EGFR Uncommon Mutations And Comparison Of First-line TKIs And Chemotherapy Efficacy

Objective: To analyze the clinicopathological features of EGFR uncommon mutations and compare the efficacy of epidermal growth factor tyrosinase inhibitors(EGFR-TKIs)with first-line chemotherapy.Methods:Non-small cell lung cancer patients who received EGFR gene test in the fourth hospital of hebei medical university from April 2012 to June 2019 were screened,and the detection results were 265 patients with EGFR uncommon mutations.The clinicopathological characteristics were analyzed,and 90 patients who received first-line targeted therapy and chemotherapy were evaluated for efficacy and survival.The follow-up period is December 20,2019.ORR,DCR,PFS,and OS were calculated for 90 treated patients.Statistical analysis was performed on the obtained data using IBM SPSS 23.0 software.The categorical variables were tested using test or Fisher's exact test.Kaplan-Meier method was used for survival analysis.Log-rank test was used for univariate analysis.COX regression was used for multivariate analysis.A two-sided probability test was used,with a statistical significance of P <0.05.Results:1.530 wild-type patients were randomly selected in the same period,and the clinical characteristics were analyzed with 265 non-smoking patients.It was found that uncommon mutation of EGFR was more likely to occur in female,non-smoking and adenocarcinoma patients(P<0.05).2.Among the 265 patients enrolled,they were divided into 6 groups according to the type of mutation,There was no significant difference in gender,age,smoking history,histological type among different subtypes(P>0.05).3.COX multivariate analysis of 265 patients showed that clinical staging was an independent prognostic factor for total survival(P<0.05),COX multivariate analysis of 90 patients who receiving first-line treatment showed that age was an independent prognostic factor for total survival(P<0.05).4.In 90 patients with recurrence or advanced non-small cell lung cancer received first-line TKIs or first-line chemotherapy,the PFS of first-line TKIs were different for different mutation types.The efficacy of the first-line TKIs treatment group was significantly better than that of the first-line chemotherapy group.(P<0.05),median overall survival m OS was 21 months and 16.5 months(P<0.05).Conclusions:1.In non-small cell lung cancer patients,EGFR uncommon mutations are more likely to occur in non-smoker,female,adenocarcinoma patients.2.There was no significant difference in gender,age,smoking history,histological type among different subtypes.3.Clinical stage and age were the independent prognostic factor affecting overall survival.4.In the recurrence and Advanced uncommon mutation patients,the survival of targeted therapy in each mutation subtype is different,but the first-line targeted therapy is better than the first-line chemotherapy in both PFS and OS.