scholarly journals Outcomes After Combined Modality Therapy for EGFR ‐Mutant and Wild‐Type Locally Advanced NSCLC

2011 ◽  
Vol 16 (6) ◽  
pp. 886-895 ◽  
Author(s):  
Raymond H. Mak ◽  
Elizabeth Doran ◽  
Alona Muzikansky ◽  
Josephine Kang ◽  
Joel W. Neal ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Wild Type ◽  
Combined Modality ◽  
Locally Advanced Nsclc ◽  
Egfr Mutant

The Outcome of Combined-Modality Therapy for Stage III Non–Small-Cell Lung Cancer in the Elderly

2003 ◽  
Vol 21 (17) ◽  
pp. 3201-3206 ◽  
Author(s):  
Steven E. Schild ◽  
Philip J. Stella ◽  
Susan M. Geyer ◽  
James A. Bonner ◽  
William L. McGinnis ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Advanced Nsclc ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Survival Rates ◽  
The Elderly ◽  
Small Cell Lung ◽  
Combined Modality ◽  
Locally Advanced Nsclc ◽  
To Receive

Purpose: The North Central Cancer Treatment Group performed a phase III trial to determine whether chemotherapy plus either bid radiation therapy (RT) or daily (qd) RT resulted in a better outcome for patients with stage III non–small-cell lung cancer (NSCLC). No difference in survival was identified between the two arms. This secondary analysis was performed to examine the relationship between patient age and outcome. Patients and Methods: Two hundred forty-six patients were randomized to receive etoposide plus cisplatin and either RT qd or split-course RT bid. This retrospective study compared the outcomes of patients aged ≥70 years (“elderly patients”) with those of younger individuals. Of the 244 assessable patients, 63 (26%) were elderly, and 181 (74%) were younger individuals. Results: The 2-year and 5-year survival rates were 39% and 18%, respectively, in patients younger than 70 years, compared with 36% and 13%, respectively, in elderly patients (P = .4). Grade 4+ toxicity occurred in 62% of patients younger than 70 years compared with 81% of elderly patients (P = .007). Grade 4+ hematologic toxicity occurred in 56% of patients younger than 70 years, compared with 78% of elderly patients (P = .003). Grade 4+ pneumonitis occurred in 1% of those younger than 70 years, compared with 6% of elderly patients (P = .02). Conclusion: Toxicity, especially myelosuppression and pneumonitis, was more pronounced in the elderly patients receiving combined-modality therapy for locally advanced NSCLC. Despite increased toxicity, elderly patients have survival rates equivalent to younger individuals. Therefore, fit, elderly patients with locally advanced NSCLC should be encouraged to receive combined-modality therapy, preferably on clinical trials with cautious, judicious monitoring. Future studies should explore ways to decrease toxicity of therapy in elderly patients.

scholarly journals Efficacy and Safety Aiming at the Combined-Modality Therapy of External Beam Radiotherapy (40Gy) and Iodine-125 Seed Implantation for Locally Advanced NSCLC in the Elderly

2020 ◽  
Author(s):  
LiJun Tian ◽  
HongZhi Liu ◽  
Qiang Zhang ◽  
Dian-Zhong Geng ◽  
Yu-Qing Huo ◽  
...  
Keyword(s):  
Chest Wall ◽  
Advanced Nsclc ◽  
Combined Modality Therapy ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
The Elderly ◽  
Seed Implantation ◽  
Combined Modality ◽  
Locally Advanced Nsclc ◽  
Iodine 125

Abstract Background Our retrospective study aimed to evaluate the efficacy and safety of the combined-modality therapy for tumor invading the chest wall of locally advanced non-small-cell lung cancer (NSCLC) in the elderly. Methods We retrospectively enrolled 21 elderly patients (aged ≥ 60 years) with locally advanced NSCLC diagnosed as tumor invading the chest wall. The prescription dose of the primary tumor adopting external beam radiotherapy (EBRT) was given 40 Gy which was supplemented with iodine-125 seed implantation, meanwhile the lymph nodes of mediastinum undergoing EBRT was given 60 Gy. Follow-up was conducted every 3 months postoperatively. The related analytic parameters were the change of tumor size, the objective response rate (ORR), the disease control rate (DCR), the degree of pain relief, the improvement of physical status and the toxicity. Results The combined-modality therapy could significantly inhibit the local growth of tumor (from 7.84 ± 1.20 to 4.69 ± 1.90 cm) (P < 0.0001), indicating a better validity with an ORR of 71.4% and DCR 90.5%, respectively at 1 year. The cancer-related pain was significantly relieved (P < 0.05) and the physical status were also significantly improved (P < 0.05). There was no procedure-associated death or grade > 2 irradiation-related adverse effect in our study. Conclusions The combined-modality therapy of EBRT with 40 Gy and permanent iodine-125 seed implantation is an efficacious and safe option and may be recommended as a treatment pattern for the elderly of locally advanced NSCLC with tumor invading the chest wall.

High efficacy of paclitaxel (P), carboplatin (C) and concurrent thoracic radiation therapy (TRT) for locally advanced non-small cell lung cancer (NSCLC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17143-17143
Author(s):  
K. Kishi ◽  
A. Okazaki ◽  
H. Takaya ◽  
A. Miyamoto ◽  
S. Sakamoto ◽  
...  
Keyword(s):  
Weight Loss ◽  
Advanced Nsclc ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Chemotherapeutic Agents ◽  
Stage Iiia ◽  
Number Of Patients ◽  
Locally Advanced Nsclc ◽  
Thoracic Radiation ◽  
Grade 3

17143 Background: Combined modality therapy with P, C and radiation for locally advanced NSCLC is active, but its clinical data are limited in Japan. The aim of this study is to evaluate feasibility and efficacy of the therapy in a Japanese general hospital. Methods: Patients with previously untreated and locally advanced NSCLC with stage IIIA and IIIB (PS 0–1, weight loss less than 5% over past 3 months) were treated with P (40 mg/m2 on days 1,8,15, 22, 29, 36, 43), C (AUC 2 on days 1,8,15, 22, 29, 36, 43) and TRT (66 Gy/33fr over 6.5 weeks starting on day1). Results: Fifteen evaluable patients entered this study between December 2001 and March 2005. They were 12 males, 3 females, with median age 67 (57–76); 6 patients with ECOG PS 0, 9 with PS 1, 8 with stage IIIA, and 7 with IIIB. Chemotherapeutic agents were administered a median of 6 cycles (4–7) and 66 Gy of TRT done in 14 patients. It achieved 13 PRs, 1 SD and 1 PD with a response rate of 86.7%. Survival was 85.5% at 1 year, 66.0% at 2 year and 66.0% at 3 year. Eleven patients are still alive. A relapse occurred in 10 patients (66.7%) and 5 were disease-free (33.3%). The site of first relapse was distant in 5 patients, local in 3, and both local and distant in 2. Toxicity was mild: grade 3 neutropenia in 2 patients, grade 3 nausea in 1, and grade 3 esophagitis in 1. No grade 3/4 pneumonitis was observed. After completion of chemoradiotherapy scheduled, 2 patients received additional chemotherapy of PC and 1 underwent lobectomy. Conclusion: Although the number of patients is small in this study, concurrent PC and TRT for locally advanced NSCLC is feasible and highly effective for Japanese patients with good PS and minimal weight loss. No significant financial relationships to disclose.

scholarly journals Efficacy of erlotinib as neoadjuvant regimen in EGFR-mutant locally advanced non-small cell lung cancer patients

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051988727 ◽  
Author(s):  
Liwen Xiong ◽  
Yuqing Lou ◽  
Hao Bai ◽  
Rong Li ◽  
Jinjing Xia ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Advanced Nsclc ◽  
Response Rate ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Locally Advanced Nsclc ◽  
Iiia Nsclc ◽  
Egfr Mutant

Background The optimal neoadjuvant regimen for locally advanced resectable non-small cell lung cancer (NSCLC) remains controversial. EGFR inhibitors have significantly improved survival in patients with EGFR-mutant advanced NSCLC. However, their efficacy in neoadjuvant settings, particularly for treating locally advanced NSCLC, remains unclear. We compared the clinical benefits of chemotherapy and erlotinib as neoadjuvant therapy for stage IIIA NSCLC. Method Thirty-one treatment-naïve Chinese patients with stage IIIA NSCLC were enrolled. Patients without EGFR mutation received cisplatin-based doublet chemotherapy (n = 16; N-chemo group) while EGFR-mutant patients received erlotinib (n = 15; N-TKI group) as neoadjuvant therapy. Results After completing neoadjuvant treatment, 12 and 8 patients from the N-TKI and N-chemo groups underwent surgery, respectively. Our data revealed that patients who received erlotinib had a marginally better clinical objective response rate (67% vs. 19%), pathological response rate (67% vs. 38%), and overall survival (51.0 months vs. 20.9 months) compared with those who received chemotherapy. Furthermore, patients in the N-TKI group had a significantly greater reduction in tumor diameter, serum carcinoembryonic level, and maximum allelic fraction. Conclusion Our findings demonstrate that erlotinib is an effective neoadjuvant regimen in patients with EGFR-mutant locally advanced NSCLC, paving the way for its extended use in neoadjuvant settings. [ClinicalTrials.gov identifier: NCT01217619]

Multiinstitutional phase II trial of paclitaxel, carboplatin, and concurrent radiation therapy for locally advanced non-small-cell lung cancer.

1998 ◽  
Vol 16 (10) ◽  
pp. 3316-3322 ◽  
Author(s):  
H Choy ◽  
W Akerley ◽  
H Safran ◽  
S Graziano ◽  
C Chung ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Phase Ii ◽  
Advanced Nsclc ◽  
Response Rate ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Free Survival ◽  
Locally Advanced Nsclc

PURPOSE Combined modality therapy for non-small-cell lung cancer (NSCLC) has produced promising results. A multiinstitutional phase II clinical trial was conducted to evaluate the activity and toxicity of paclitaxel, carboplatin, and concurrent radiation therapy on patients with locally advanced NSCLC. PATIENTS AND METHODS Forty previously untreated patients with inoperable locally advanced NSCLC entered onto a phase II study from March 1995 to December 1996. On an outpatient basis for 7 weeks, patients received paclitaxel 50 mg/m2 weekly over 1 hour; carboplatin at (area under the curve) AUC 2 weekly; and radiation therapy of 66 Gy in 33 fractions. After chemoradiation therapy, patients received an additional two cycles of paclitaxel 200 mg/m2 over 3 hours and carboplatin at AUC 6 every 3 weeks. RESULTS Thirty-nine patients were eligible for the study. The survival rates at 12 months were 56.3%, and at 24 months, 38.3%, with a median overall survival of 20.5 months. The progression-free survival rates at 12 months were 43.6%, and at 24 months, 34.7%, with a median progression-free survival of 9.0 months. Two patients did not receive more than 2 weeks of concurrent chemoradiotherapy and were not assessable for toxicity and response. The overall response rate (partial plus complete response) of 37 assessable patients was 75.7%. The major toxicity was esophagitis. Seventeen patients (46%) developed grade 3 or 4 esophagitis. However, only two patients developed late esophageal toxicity with stricture at 3 and 6 months posttreatment. CONCLUSION Combined modality therapy with paclitaxel, carboplatin, and radiation is a promising treatment for locally advanced NSCLC that has a high response rate and acceptable toxicity and survival rates. A randomized trial will be necessary to fully evaluate the usefulness of these findings.

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