What is the impact of the inherent EGFR gene mutation on the targeted therapy of lung cancer?

With the development of medicine and the continuous upgrading of treatment methods, the popularization and application of gene sequencing technology in the field of tumor treatment has become more common
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In many cases, the results of gene sequencing greatly determine the patient's subsequent treatment options
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So if it is detected that the patient is carrying a blastoblast mutation of the EGFR gene, what impact will it have on subsequent treatment? What is a germ cell mutation? Germ cell mutations, also called germ cell mutations, refer to genetic mutations inherited from parents and innate.
All human cells, including germ cells, carry such mutations; the other kind of mutation is somatic mutation, which is Refers to mutations that occur during acquired development or under the influence of the environment.
These mutations often lead to tumors.
For example, we often hear about EGFR and ALK gene mutations in lung cancer
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This type of mutation only exists in tumors, not in other normal tissues
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If a lung cancer patient carries a genetic mutation in the embryonic cell, it means that all cells in his body carry this inborn genetic mutation.
What impact will this have on the patient's treatment? The following research data gives us the answer
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Lung cancer patients carrying both EGFR mutations have a poor prognosis after treatment.
Researchers used second-generation gene sequencing technology to sequence the patient’s tumor tissue samples and blood samples, and a total of 1021 genes were detected
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The researchers found six patients with both EGFR gene germ cell mutations and somatic mutations
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In other words, the cells of the six patients all carry an EGFR gene mutation, and the tumor cells carry another new EGFR gene mutation
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The six patients had very different responses to targeted drugs
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Four patients have died and the median overall survival time is 15 months
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The median progression-free survival time of EGFR-targeted drug therapy is four months, which is much shorter than that of patients without EGFR blast cell mutations
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Figure 1.
Different patients with lung cancer who carry germ cell and somatic EGFR mutations have different effects of targeted therapy.
Six patients used different targeted drugs, and the prognosis was very different
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Some patients used the first-generation EGFR-targeted drug gefitinib in second-line treatment, and the median progression-free survival time was only 8 months
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For an 81-year-old male patient who also had the same gene mutation, chemotherapy was also used in the first line, and gefitinib was used in the second line for targeted therapy, but the disease progressed rapidly and the overall survival time was only 8 months
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Some patients used gefitinib on the first line, and their condition progressed rapidly within one month, and the next treatment effect was not good.
He died 8 months after the diagnosis
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The median progression-free survival time of another patient with the same mutation treated with gefitinib was 29 months
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Figure 2.
Different EGFR gene mutations affect the efficacy of tumors for targeted therapy.
Researchers have found that the P848L germ cell mutation of the EGFR gene can cause tumor cells to be resistant to multiple targeted drugs
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In addition, cancer cells with both EGFR K757R germ cell mutations and somatic mutations with exon 19 deletion are more sensitive to targeted therapies.
Some patients were treated with icotinib and osimertinib, with no progress in the median.
The survival time reached 36 months and 12 months respectively
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Enlightenment that lung cancer patients carry blast cell mutations in the EGFR gene.
Although this situation is rare, it is not completely non-existent
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The correct interpretation of the genetic test report is especially important, which is related to the choice of subsequent treatment options
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Cancer Degree reminds everyone that if you decide to conduct gene sequencing, you must choose a regular genetic testing company, and their test report will give a more detailed interpretation and analysis
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According to the situation of different gene mutation sites, as well as the current clinical research support, etc.
, the test report should all be listed
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A detailed and professional genetic test report is more conducive to the attending doctor in the follow-up treatment as a reference to better decide the next treatment measures
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We cannot choose and change what kind of genetic mutation the tumor has
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However, we can plan the overall treatment according to scientific and professional knowledge, and adjust the treatment drugs and programs in time according to our own situation during the treatment process, and strive to achieve the best curative effect
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If you want to learn about professional genetic testing report templates, you can enter the genetic testing section of the Cancer Degree app and the Cancer Degree Official Account, and contact the consultants of BGI for consultation at any time
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For more tumor treatment knowledge, welcome to download the cancer degree app
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Reference: Yifen Wu, et al.
, Diverse responses to EGFR-TKIs in patients with concurrent germline and somatic EGFR mutations, Lung Cancer, 2021 Click below to learn more about clinical trial items Cancer Degree Jing/Color/Return/Gu 01020304 Swipe to see more