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Background  We compared the therapeutic effect of EGFR‐tyrosine kinase inhibitors (TKIs) on 19Del and L858R mutations in advanced lung adenocarcinoma on cellular immune function and explored the factors influencing the curative effect and prognosis.    Methods  Clinical efficacy in the selected 71 patients with lung adenocarcinoma, including 52 patients with 19Del and L858R mutations and 19 wild type patients treated with EGFR‐TKIs was retrospectively analyzed. The response rate (RR), disease control rate (DCR), progression‐free survival (PFS), overall survival (OS), and cellular immune function were analyzed.    Results  The RR, DCR, PFS, and OS of the 19Del group were higher than those of the L858R group; however, there were no statistically significant differences between the groups. χ 2 test results revealed that gender, smoking, and  EGFR  mutations were associated with DCR. Log‐rank analytical results showed that  EGFR  mutation type was correlated to PFS and OS. Multivariate analysis implied that disease control and mutation type of  EGFR  were independent prognostic factors of OS. Following TKI treatment, the number of CD3+, CD4+, and NK cells and the CD4+/CD8+ratio increased in both mutation groups; however the results were not statistically significant. There was also no significant difference in the upregulation of immunological function observed, with 46.43% in the 19Del mutation and 45.83% in the L858R mutation group.    Conclusion   EGFR  19Del and L858R mutations are good biomarkers for predicting the clinical response of EGFR‐TKIs. 19Del mutations may have a better clinical outcome.

thoracic cancer

Comparison of therapeutic effects of EGFR‐tyrosine kinase inhibitors on 19Del and L858R mutations in advanced lung adenocarcinoma and effect on cellular immune function