Therapeutic Effect Of Targeted Drugs On Lung Adenocarcinoma Patients With EGFR Gene 19del And L858R Mutation

Objective: To explore the therapeutic effect differences of different targeted drugs on lung adenocarcinoma patients with EGFR gene 19 del and L858 R mutation.Materials and Methods: We collected 40 inoperable patients with stage IIIb and IV lung adenocarcinoma who were admitted to our Department of Oncology from May2017 to December 2018.All patients were positive for EGFR gene test and received standardized targeted drug EGFR-TKI(erlotinib,gefitinib)treatment.The cases were divided into EGFR gene 19 del mutation group and L858 R mutation group according to the mutation type.The efficacy was evaluated by the new RECIST 1.1[1],and the clinical features and differences in efficacy were compared.Differences in the efficacy of erlotinib and gefitinib between the two groups were compared by calculating the patient's ORR and DCR;Survival analysis was performed using the Kaplan-Meier method to compare whether the tumor progression-free survival distribution was the same.Results: Among the 40 patients,the clinical characteristics of the two groups,such as age,gender,smoking history,clinical stage,etc.P>0.05,difference was not statistically significant,the brain metastasis ratio of the two groups was statistically different(P=0.027);The median progression-free survival(PFS)of the EGFR gene19 del mutant was longer than that of the EGFR gene L858 R mutant(17.2 months vs12 months,log-rank P=0.036);EGFR gene 19 del mutation group: erlotinib ORR =78.57%,DCR = 85.71%;gefitinib ORR = 60.0%,DCR = 90.0%.EGFR gene L858 R mutation group: erlotinib ORR = 71.43%,DCR = 71.43%;gefitinib ORR = 33.3%,DCR = 88.89%.Erlotinib ORR was higher in both groups than in gefitinib,while gefitinib DCR was relatively high.Conclusions: EGFR gene 19 del mutation in late lung adenocarcinoma compared to EGFR gene L858 R mutation,Patients have a better effect on EGFR-TKI,Erlotinib has a good effect on patients with lung adenocarcinoma with EGFR-sensitive mutations,and provides a basis for clinical guidance to develop treatment plans.