Survival And Prognosis Analyses Of Concurrent PIK3CA Mutations In EGFR Mutant Non-small Cell Lung Cancer Treated With EGFR Tyrosine Kinase Inhibitors

Purpose:In non-small cell lung cancer(NSCLC)patients with epidermal growth factor receptor(EGFR)mutation,the prognostic impact of a concurrent Phosphoinositide-3-kinase catalytic alpha polypeptide(PIK3CA)mutation was still unknown.Some studies have shown that EGFR mutant NSCLC patients treated with EGFR tyrosine kinase inhibitors(TKIs)when concurrent PIK3 CA mutation have a worse prognosis and shorter survival time.This study investigated the impact of combined PIK3 CA mutation on survival and prognosis in NSCLC patients with EGFR mutant in response to EGFR-TKIs.Methods:This study conducted a retrospective analysis of NSCLC patients with EGFR mutant or concurrent PIK3 CA mutations from January 2015 to October 2019 in the First Affiliated Hospital of Nanchang University.Reference WHO solid tumor curative effect evaluation criteria in solid tumors(RECIST)evaluation objective response rate(ORR),disease control rates(DCR),time to progression(TTP)and overall survival(OS),and the clinical features of each patient were retrospectively reviewed.The TTP and OS were calculated by the Kaplan-Meier method and compared between double-mutant(EGFR mutation concurrent PIK3 CA mutation)and EGFR single-mutant patients were performed by log-rank tests.Result:Patients with EGFR mutant NSCLC co-exist with PIK3 CA mutation had a shorter median TTP: 7.8 months versus 10.9 months(Double-Mt versus Single-Mt,p= 0.001),and a decrease in median OS: 20.6 months versus 32.4 months(p < 0.001).The 0RR between Double-Mt and Single-Mt was 36.7% versus 61.9%(p = 0.044),DCR was 80.1% versus 91.7%(p = 0.179).And 62 of the 81(76.5%)patients reported a total of 109 EGFR-TKIs related adverse events,but no statistical difference between the two groups(p = 0.215).Conclusion:EGFR-TKIs for EGFR mutate NSCLC patients when concurrent PIK3 CA mutations have a worse prognosis and shorter survival time.