TREATMENT WITH EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITOR IN PATIENTS WITH NON-SMALL CELL LUNG CANCER: EXPERIENCE OF KAUNO KLINIKOS

Abstract

Objective. To evaluate the results of the repeated epidermal growth factor receptor (EGFR) genemutation assays, the detection of resistant EGFR genemutation T790M and the efficacy of the treatment with third generation EGFR tyrosine kinase inhibitor (TKI) in patientswith locally advanced ormetastatic non-small cell lung cancer (NSCLC) treatedwith first- or second-generation EGFR TKI.Methods.A retrospective analysis of 92 patients with locally advanced ormetastatic NSCLC, who were treated with EGFR TKI at the Hospital of Lithuanian University of Health Sciences Kauno Klinikos from 1 January 2008 to 1 January 2019, was performed. The data collected frommedical documentation: duration of the lifetimewithout disease progression, the results of the repeated EGFR genemutation assays, the detection of resistant EGFR genemutation T790M and the treatment with third generation TKI. Results. The median duration of the lifetime without disease progression was 13.3 months (95% confidence interval (CI), 11.1–15.5 months). The repeated EGFR gene mutation assay (tumor tissue biopsy or/and liquid biopsy) with disease progression was performed in 31 patients with NSCLC. The resistant EGFR gene mutation T790M was detected in 16 (51.6%) patients with NSCLC. Ten of them were treated with third generation EGFR TKI. The median duration of the lifetime without disease progression was 15.2 months (95 % CI, 3.8–26.6 months). Conclusions. In patients with locally advanced or metastatic NSCLC treated with first- or second-generation EGFR TKI, duration of the lifetime without disease progression was more than one year. The resistant EGFR gene mutation T790M was detected in more than half patients with NSCLC. In these patients, treatmentwith third-generation EGFR TKI, statistically significantly prolongs survival until disease progression.