scholarly journals Identification of Stage IIIC/IV EGFR-Mutated Non-Small Cell Lung Cancer Populations Sensitive to Targeted Therapy Based on a PET/CT Radiomics Risk Model

2021 ◽  
Vol 11 ◽  
Author(s):  
Dan Shao ◽  
Dongyang Du ◽  
Haiping Liu ◽  
Jieqin Lv ◽  
You Cheng ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Second Generation ◽  
External Validation ◽  
Rapid Progression ◽  
First Line ◽  
Stage Iiic ◽  
Pet Ct ◽  
First And Second Generation ◽  
Egfr Mutated ◽  
Egfr Tki

ObjectivesThis project aimed to construct an individualized PET/CT prognostic biomarker to accurately quantify the progression risk of patients with stage IIIC-IV epidermal growth factor receptor (EGFR)-mutated Non-small cell lung cancer (NSCLC) after first-line first and second generation EGFR- tyrosine kinase inhibitor (TKI) drug therapy and identify the first and second generation EGFR-TKI treatment-sensitive population.MethodsA total of 250 patients with stage IIIC-IV EGFR-mutated NSCLC underwent first-line first and second generation EGFR-TKI drug therapy were included from two institutions (140 patients in training cohort; 60 patients in internal validation cohort, and 50 patients in external validation cohort). 1037 3D radiomics features were extracted to quantify the phenotypic characteristics of the tumor region in PET and CT images, respectively. A four-step feature selection method was performed to enable derivation of stable and effective signature in the training cohort. According to the median value of radiomics signature score (Rad-score), patients were divided into low- and high-risk groups. The progression-free survival (PFS) behaviors of the two subgroups were compared by Kaplan–Meier survival analysis.ResultsOur results shown that higher Rad-scores were significantly associated with worse PFS in the training (p < 0.0001), internal validation (p = 0.0153), and external validation (p = 0.0006) cohorts. Rad-score can effectively identify patients with a high risk of rapid progression. The Kaplan–Meier survival curves of the three cohorts present significant differences in PFS between the stratified slow and rapid progression subgroups.ConclusionThe PET/CT-derived Rad-score can realize the precise quantitative stratification of progression risk after first-line first and second generation EGFR-TKI drug therapy for NSCLC and identify EGFR-mutated NSCLC populations sensitive to targeted therapy, which might help to provide precise treatment options for NSCLC.

Emergence of RET rearrangement co-existing with activated EGFR mutation in EGFR -mutated NSCLC patients who had progressed on first- or second-generation EGFR TKI

Lung Cancer ◽  
2015 ◽  
Vol 89 (3) ◽  
pp. 357-359 ◽  
Author(s):  
Samuel J. Klempner ◽  
Lyudmila A. Bazhenova ◽  
Fadi S. Braiteh ◽  
Petros G. Nikolinakos ◽  
Kyle Gowen ◽  
...  
Keyword(s):  
Second Generation ◽  
Egfr Mutation ◽  
Ret Rearrangement ◽  
Nsclc Patients ◽  
Egfr Mutated ◽  
Egfr Tki

scholarly journals The Efficacy of Traditional Chinese Herbal Medicine in the Treatment of EGFR Mutated Stage IV Pulmonary Adenocarcinoma Patients Who Received First-Line EGFR-TKI Treatment

2016 ◽  
Vol 16 (1) ◽  
pp. 126-131 ◽  
Author(s):  
Hsiu-Ying Hung ◽  
Yen-Han Tseng ◽  
Chia-Miao Liao ◽  
Sung-Yi Chen ◽  
Ta-Peng Wu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Herbal Medicine ◽  
Chinese Herbal Medicine ◽  
Stage Iv ◽  
Pulmonary Adenocarcinoma ◽  
First Line ◽  
Chinese Herbal ◽  
Tki Treatment ◽  
Egfr Mutated ◽  
Egfr Tki

Background. Chinese herbal medicine (CHM) has been used for thousands of year in Eastern countries. First-line epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment is the standard treatment in stage IV pulmonary adenocarcinoma patients who had tumor EGFR mutations. This study was to find the efficacy of CHM on lung cancer treatment. Materials and Methods. We retrospectively reviewed chart records of our stage IV EGFR-mutated pulmonary adenocarcinoma patients who received first-line EGFR-TKI treatment from January 2010 to September 2014. Results. Total, 527 patients were studied. Among them, 34 patients received CHM treatment, including 24 patients who received CHM treatment from the beginning of first-line EGFR-TKI treatment and 10 patients who started to receive CHM treatment after their disease had progressed to EGFR-TKI treatment. Median progression-free survival (PFS) of first-line EGFR-TKI treatment was numerically better in patients who also received CHM than those who did not (12.1 months vs 10.5 months, P = .7668). Overall survival of those 24 patient who received CHM treatment together with EGFR-TKI was 30.63 months (95% CI = 11.7 to not reached), compared to 23.67 months in the remaining patients (95% CI = 21.37-26; hazard ratio = 0.75; P = .399). No increase of CHM-related toxicities was found during CHM treatment, compared with EGFR-TKI treatment alone ( P > .05). Conclusion. Alternative CHM treatment during first-line EGFR-TKI treatment did no harm to the patients and PFS and overall survival was numerically better, although not significant, than those patients who did not receive CHM treatment.

scholarly journals MA08.05 Depth of Response to First-Line EGFR TKI Does Not Predict Survival in EGFR-Mutated NSCLC Patients

2017 ◽  
Vol 12 (1) ◽  
pp. S386-S387
Author(s):  
Ting-Hui Wu ◽  
Emily Hsiue ◽  
Jih-Hsiang Lee ◽  
James Chih-Hsin Yang
Keyword(s):  
First Line ◽  
Depth Of Response ◽  
Nsclc Patients ◽  
Egfr Mutated ◽  
Egfr Tki

scholarly journals Cell Line Models for Acquired Resistance to First-Line Osimertinib in Lung Cancers—Applications and Limitations

Cells ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 354
Author(s):  
Shuta Ohara ◽  
Kenichi Suda ◽  
Tetsuya Mitsudomi
Keyword(s):  
Cell Line ◽  
Cell Lines ◽  
Second Generation ◽  
Acquired Resistance ◽  
Research Groups ◽  
First Line ◽  
Lung Cancers ◽  
Mesenchymal Transition ◽  
First And Second Generation ◽  
Egfr Tkis

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are first-line drugs for lung cancers with activating EGFR mutations. Although first- and second-generation EGFR-TKIs were standard first-line treatments, acquired resistance (AR) to these drugs is almost inevitable. Cell line models have been widely used to explore the molecular mechanisms of AR to first- and second-generation EGFR-TKIs. Many research groups, including ours, have established AR cell lines that harbor the EGFR T790M secondary mutation, MET gene amplification, or epithelial–mesenchymal transition (EMT) features, which are all found in clinical specimens obtained from TKI-refractory lesions. Currently, many oncologists prescribe osimertinib, a third-generation EGFR-TKI that can overcome T790M-mediated resistance, as a first-line TKI. Although few clinical data are available about AR mechanisms that arise when osimertinib is used as a first-line therapy, many research groups have established cell lines with AR to osimertinib and have reported on their AR mechanisms. In this review, we summarize the findings on AR mechanisms against first-line osimertinib obtained from analyses of cell line models.

scholarly journals Evaluation of Patients with Lung Cancer Treated with Epidermal Growth Factor Receptor–Tyrosine Kinase Inhibitor

2018 ◽  
Vol 04 (02) ◽  
pp. 048-053
Author(s):  
Laksmi Wulandari ◽  
Anna Febriani ◽  
Farah Fatmawati ◽  
Gatot Soegiarto
Keyword(s):  
Lung Cancer ◽  
General Hospital ◽  
Receptor Tyrosine Kinase ◽  
Kinase Inhibitor ◽  
Objective Response ◽  
Growth Factor Receptor ◽  
First Line ◽  
Epidermal Growth ◽  
Egfr Mutated ◽  
Egfr Tki

AbstractEpidermal growth factor receptor–tyrosine kinase inhibitor (EGFR-TKI) is currently the standard therapy for EGFR-mutated non–small cell lung cancer (NSCLC). Gefitinib is the first EGFR-TKI marketed in Indonesia and has been used since 2012 in Dr. Soetomo General Hospital, a tertiary hospital in Surabaya, East Java, Indonesia. Although the drug had shown some positive results, the overall treatment outcome for Indonesian patients has not been reported yet. The aim of the study is to evaluate the progression-free survival (PFS), overall survival (OS), and subjective response of gefitinib as first-line treatment in advanced EGFR-mutated NSCLC patients in Dr. Soetomo General Hospital. This retrospective study includes all eligible patients treated from 2013 to 2016. Demographic data, performance status, tumor histopathologic types, treatment response, and adverse effects (AEs) during the treatment course were collected from patient's medical records. Objective response was based on RECIST 1.1. Quality of life was assessed using Eq. 5D questionnaire. From evaluable data of 63 patients, median PFS was 8.3 months (95% confidence interval [CI: 6.50–10.2) with median OS of 16 months (95% CI: 11.9–20.2). Eq. 5D scores were decreased in 21 (33.3%) patients, stable in 22 (34.9%), and increased in 20 (31.7%). The most common side effects were itchy skin rash in 52 (82%) patients and diarrhea in 29 (46%). Gefitinib as first-line therapy provides a good objective response and is generally well tolerated in patients with EGFR-mutated NSCLC in Dr. Soetomo General Hospital.

Treatment sequence of first and second generation tyrosine kinase inhibitor followed by osimertinib in EGFR-mutated non-small-cell lung cancer: a real life study

2020 ◽  
Vol 16 (16) ◽  
pp. 1115-1124
Author(s):  
Nicolas Girard ◽  
Denis Moro-Sibilot ◽  
Stéphane Bouée ◽  
Corinne Emery ◽  
Elodie Torreton ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Tyrosine Kinase ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Second Generation ◽  
Real Life ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Egfr Mutated

Background: We aimed to assess the effectiveness and cost of patients with first line tyrosine kinase inhibitors (TKIs) sequence of first (1G) and second generation (2G) followed by osimertinib. Materials & methods: Using the French nationwide claims and hospitalization database, we analyzed non-small-cell lung cancer patients who had been treated with osimertinib between April 2015 and December 2017, after a first line treatment with a TKI-1G/2G. Results: The median time on treatment for sequential TKI-1G/2G followed by osimertinib was 34 months (95% CI: 31–46); 13 and 12months, respectively for TKI 1G or 2G and TKI 3G, respectively. The median overall survival for sequential TKI 1G or 2G followed by osimertinib was 37 months (95% CI: 34–42). The mean monthly costs per patient was €5162. Conclusion: These results, in line with those observed during clinical trials, confirm the effectiveness of the sequence TKI-1G/2G followed by osimertinib in EGFR-mutated non-small-cell lung cancer.

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