The alteration of T790M between 19 del and L858R in NSCLC in the course of EGFR-TKIs therapy: a literature-based pooled analysis

Journal of Thoracic Disease
Hengrui Liangwritten on behalf of AME Lung Cancer Cooperative Group

Abstract

Treatment-naive epidermal growth factor receptor (EGFR) T790M mutation is more inclined to coexist with L858R than with 19 del in non-small cell lung cancer (NSCLC) patients. However, EGFR-tyrosine kinase inhibitors (EGFR-TKIs) might alter this status. We sought to compare the prevalence of T790M upon acquired resistance to EGFR-TKIs between 19 del and L858R by assembling all existing data. Electronic databases were comprehensively searched for eligible studies. The primary endpoint was the odds ratio (OR) of T790M mutation in NSCLC co-existing with L858R mutation and 19 del upon resistance to first-generation EGFR-TKIs. A random effects model was used. Stratified analysis was performed based on study type (retrospective and prospective), race (Asians and Caucasians) and sample type (tissue and plasma). A total of 25 studies involving 1,770 patients were included. The overall T790M existent rate was 45.25%. Post-resistance T790M was more frequent in 19 del than in L858R mutated patients (53% vs. 36%; OR 1.87; P<0.001). All outcomes of subgroup and overall analyses were similar. In contrast, we re-analyzed the previous meta-analysis, finding that the pooled rate of pretreatment T790M was 14% and 22% in 19 del and L858R respectiv...Continue Reading

Citations

Nov 7, 2019·Journal of Cancer Research and Clinical Oncology·Yuan TangDongmei Lin
Oct 4, 2020·Journal of the Chinese Medical Association : JCMA·Nalini Devi VerusingamMong-Lien Wang
Jul 10, 2021·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Ha-Ram ParkDae Seog Heo
Sep 12, 2020·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Jianchun DuanJie Wang

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