Effect of hydrothorax EGFR gene mutation and EGFR-TKI targeted therapy on advanced non-small cell lung cancer patients

Abstract

Lung cancer is a malignancy with the highest incidence of morbidity and mortality worldwide. The lack of effective detection methods leads to the ineffectiveness of convetional therapy. The aim of the current study was to analyze the hydrothorax epidermal growth factor receptor (EGFR) mutation in patients with advanced non-small lung cancer (NSCLC) and malignant pleural effusion. A new method for clinical treatment was developed through a comparison of the difference of EGFR tyrosine kinase inhibitor (EGFR-TKI)-targeted therapy. Between January 2013 and January 2015, 68 cases diagnosed with advanced non-small lung cancer and malignant pleural effusion, were enrolled in the study. Previous first-line chemotherapeutic treatment schemes had been unsuccessful. EGFR 19 and EGFR 21 sites were detected for all the patients. Platinum-based drugs were provided for patients with wild-type EGFR. These patients served as the control group and underwent four cycles of treatments, with each cycle lasting 3 weeks. TKI medicine Gefitinib (Iressa™) was administered to patients with mutant EGFR tid, po, for a duration of 4–8 months. These patients served as the experimental group. There were 41 cases of EGFR mutations, of which 13 cases had EGFR 19 site mutations, 16 cases EGFR 21 site mutations, and the remaining 12 cases had 2 site mutations. EGFR mutations were not significant for gender, age, tumor type, stage and diameter (P>0.05). The results showed that the six-month survival rate, progression-free survival time (PFS), objective response rate (RP) and disease control rate (DCR) in the experimental group were higher than those in the control group. The drug side-effects in the experimental group indicated no statistical differences compared to the control group (P>0.05). The incidence of EGFR mutation was higher in patients with advanced non-small lung cancer and malignant pleural effusion. Targeted therapy improved the survival rate and was deemed to be a safe and effective method for patients with EGFR mutations.

An exploration of the clinical progression models of osimertinib in the treatment of advanced EGFR-mutant non-small cell lung cancer

“…Previous studies have demonstrated that patients with NSCLC with malignant pleural effusion have a higher incidence of positive EGFR mutations, and that EGFR-TKI drugs have a good effect on this type of patient (27,28). The relationship between pleural metastases and malignant pleural effusion was also explored in the present study.…”

Sample types applied for molecular diagnosis of therapeutic management of advanced non-small cell lung cancer in the precision medicine

“…DNA concentrations of >2-25 ng/μL, tumor cells >30, or a tumor percentage of >25%-30%, showed a 100% concordance with the corresponding tissue biopsies [51,52]. Among the cytology samples, pleural effusion has relatively higher rates of occurrence of EGFR mutations because most malignant tumor cells in pleural effusions are derived from advanced NSCLCs [53]. Nonetheless, when using cytology samples to detect T790M mutation, which is a secondary and low frequency mutation of the EGFR gene [23], specimens with as few as 5% of tumor cells and detection assays with higher sensitivities should be prioritized, and negative results should be interpreted with caution [11].…”

Mechanism of transmembrane and coiled‑coil domain 1 in the regulation of proliferation and migration of A549 cells

“…Lung cancer has the highest incidence of cancer morbidity and mortality worldwide (9). Non-small cell carcinoma accounts for 84% of lung cancers and the major phenotype is lung adenocarcinoma (10).…”