Pemetrexed-based chemotherapy for non-small-cell lung cancer patients with EGFR exon 20 insertion mutation: a multicenter study

作者：on behalf of AME Lung Cancer Collaborative Group, C. Xu, Wenxian Wang, Dong Wang, Qiming Wang, Xingxiang Pu, You‐cai Zhu, Jianhui Huang, Zongyang Yu, Zhaolei Cui, Xiao-Hui Chen, Jinluan Li, Yong Fang, Hong Wang, Wu Zhuang, Shi-Jie Lan, Xin Cai, Yin-Bin Zhang, Wenbin Gao, Liping Wang, Kelin She, Chuangzhou Rao, Yuefen Zhou, Meiyu Fang, Liyun Miao, Lei Lei, Tangfeng Lv, Yong Song · 发表于：Translational Lung Cancer Research · 年份：2020 · DOI：10.21037/tlcr-20-382 · 被引用次数：39 · 研究领域：Lung Cancer Treatments and Mutations、Lung Cancer Diagnosis and Treatment、Lung Cancer Research Studies

Background: Chemotherapy is the major choice for advanced non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor exon 20 insertion (EGFR ex20ins). The efficacy of pemetrexed-based with other chemotherapy regimens and EGFR ex20ins subtypes in this population has not been well studied. Methods: We screened patients with EGFR ex20ins by next-generation sequencing (NGS) from a large cohort. The clinicopathologic and medical information were collected in advanced NSCLC patients with EGFR ex20ins. We also compared the clinical outcomes among patients with different subtypes of EGFR ex20ins. Results: We retrospectively collected 119 stage IIIB/IV NSCLC patients with EGFR ex20ins from 9142 NSCLC patients across China from June 2013 to December 2018. The subtypes of EGFR ex20ins included A767_V769dupASV (33/119, 27.73%), S768_D770dupSVD (19/119, 15.97%), N771_H773dupNPH (11/119, 9.24%), A763_Y764insFQEA (2/119, 1.68%) and others (54/119, 45.38%). A total of 64.7% (77/119) of patients received pemetrexed-based first-line chemotherapy and 13.45% (16/119) of patients received pemetrexed-based second-line chemotherapy. Pemetrexed-based chemo-treated patients had longer median progression-free survival (PFS) than patients without pemetrexed-based chemo-treated (5.5 vs. 3.0 months, P=0.0026). Survival data was available for 66 patients and the median overall survival (OS) was 24.7 months. Pemetrexed-based chemo-treated patients had longer OS tendency than patients...