驱动基因阳性肺鳞状细胞癌患者临床特征及治疗预后分析OA

Objective To investigate the clinical characteristics,genomic mutation profiles,therapeutic efficacy of different first-line regimens,and patterns of genomic evolution following disease progression in patients with driver-mutation-positive squamous cell lung carcinoma(SqCLC),aiming to provide a basis for the strategic layout of precision therapy.Methods A retrospective analysis was conducted on the clinical data of 30 patients with driver-mutation-positive SqCLC treated at Beijing Hospital(National Center of Gerontology)from January 2017 to June 2025.The distribution of primary driver mutations and co-mutation gene profiles was described.The progression-free survival(PFS)of patients receiving targeted therapy or chemo-immunotherapy was compared,and genomic alterations identified in rebiopsy specimens after drug resistance were analyzed.Results Among the 30 patients,the primary driver mutations were predominantly epidermal growth factor receptor(EGFR)gene mutations(60.0%)and mesenchymal-epithelial transition factor(MET)gene amplification(26.6%),accompanied by an exceptionally high frequency of TP53 co-mutations(88.2%).For advanced patients,the median PFS of first-line targeted therapy was comparable to that of chemo-immunotherapy(24 patients;12 months vs.11 months).Ten patients rebiopsy after progression indicated that bypass activation was the primary mechanism of resistance.Conclusions The therapeutic benefit and prognosis of targeted therapy for driver-positive SqCLC are generally inferior to those of adenocarcinoma,necessitating vigilant monitoring and timely strategic adjustments.Rebiopsy at the time of disease progression is recommended to elucidate resistance mechanisms,enabling personalized sequential treatment to prolong patient survival.