Abstract:
Objective To analyze the clinical characteristics, treatments, and outcomes of lung cancer patients with NTRK mutations.
Methods The clinical data of patients with pathologically confirmed primary lung cancer and the NTRK mutation in next-generation sequencing (NGS) admitted to Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between October 2016 and November 2019 were retrospectively analyzed. The Kaplan-Meier method and the Log-rank test were used for the univariate survival analysis.
Results A total of 28 patients were enrolled. 27 patients were diagnosed as stage Ⅳ with point mutations or copy number amplifications of NTRK, and 1 patient was diagnosed as stage ⅢC with AEN-NTRK3 (A1:N18) fusion. The univariate analysis showed that the median progression-free survival (PFS) was related to the pathological pattern (adenocarcinoma vs. squamous carcinoma:9.4 months vs. 2.5months, P < 0.05). However, the PFS for first-line therapy was not related to age, gender, smoking history, site, and type of NTRK mutation or concomitant classical mutations (P>0.05, respectively). Contrastingly, the median PFS of EGFR-TKIs treatment for patients with EGFR mutant lung cancer and concomitant NTRK1 mutation was significantly longer than patients with concomitant NTRK3 mutation (12.4 months vs. 3.0 months, P < 0.05).
Conclusion Patients with NTRK mutant lung adenocarcinoma had a longer PFS than patients with lung squamous carcinoma when they received first-line therapy. EGFR mutant patients with concomitant NTRK3 mutation had a poorer prognosis than patients with concomitant NTRK1 mutation when they received EGFR-TKIs treatment. Therefore, concomitant NTRK3 mutation may be one of the poor prognostic factors of EGFR mutant lung cancer.
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