|Table of Contents|

Analysis of risk factors for first generation EGFR-TKIs resistance of lung adenocarcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2021 06
Page:
950-955
Research Field:
Publishing date:

Info

Title:
Analysis of risk factors for first generation EGFR-TKIs resistance of lung adenocarcinoma
Author(s):
KONG Jun1; YANG Xue2; XIE Weiping2; KONG Hui2
1.Department of Tuberculosis，the Second Hospital of Nanjing，Jiangsu Nanjing 211100，China;2.Department of Pulmonary and Critical Care Medicine，the First Affiliated Hospital of Nanjing Medical University，Jiangsu Nanjing 210029，China.
Keywords:
EGFR; first generation EGFR-TKIs; lung adenocarcinoma; primary resistance; risk factors
PACS:
R734.2
DOI:
10.3969/j.issn.1672-4992.2021.06.009
Abstract:
Objective:To analyze the clinical characteristics of the first generation of EGFR-TKIs resistant lung adenocarcinoma patients with EGFR mutation,provide basis for the selection of therapeutic agents for EGFR mutation patients.Methods：The clinical data of patients with lung adenocarcinoma admitted to the First Affiliated Hospital of Nanjing Medical University from January 2014 to April 2019 were retrospectively analyzed,following inclusion criteria:Patients applied first generation EGFR-TKIs as first-line treatment and followed up for more than 6 months.Based on the curative effect,patients were classified into the primary drug resistant (NR=40) and sensitive group (NS=237),then the clinical data of two groups of patients and progression-free survival after the treatment of TKIs were compared.Results：The incidence of primary resistance was 14.4%.There were statistically significant differences in smoking index (P=0.004) and lymph node metastasis (P=0.03).Patients with NSE≥10.725 ng/mL and tumor diameter≥3.55 cm were more likely to be resistant to first-generation EGFR-TKIs (P＜0.05),and the AUC values of each factor were 0.615 and 0.716,respectively.Combined with NSE and tumor diameter,the AUC was 0.735 (95%CI:0.665~0.804).Combined with NSE,tumor diameter and smoking index,the AUC was 0.751 (95%CI:0.679~0.822),which was better than the single index.Multi-factor logistic regression analysis confirmed that smoking index,lesion diameter and serum NSE concentration were independent influencing factors for predicting primary EGFR-TKIs resistance in patients with EGFR-sensitive mutations (P＜0.05).Conclusion：Those with smoking index≥400,lesion diameter≥3.55 cm and serum NSE concentration≥10.725 ng/mL are more likely to be resistant to the first-generation EGFR-TKIs.The prediction accuracy of primary resistance to first generation EGFR-TKIs is low，however the prediction model based on the three factors could improve the accuracy.

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Memo

Memo:
国家科技重大专项（编号：2018ZX10722301-002）；National Natural Science Foundation of China(No.81870054，81273571）；国家自然科学基金（编号：81870054，81273571）；江苏省卫生厅重点项目（编号：H201601）
Last Update: 1900-01-01