Adjuvant Treatment with Tyrosine Kinase Inhibitors in Epidermal Growth Factor Receptor Mutated Non-Small-Cell Lung Carcinoma Patients, Past, Present and Future

Shalata, Walid; Jacob, Binil Mathew; Agbarya, Abed

doi:10.3390/cancers13164119

Cited by 10 publications

(12 citation statements)

References 28 publications

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“…Non-small cell lung cancer (NSCLC) is the predominant form of lung cancer, accounting for about 80% of all lung cancer cases. Histologically, NSCLC is divided into adenocarcinoma, squamous cell carcinoma (SCC), large cell carcinoma, and adenosquamous [ 1 , 5 , 6 ]. The high morbidity and mortality associated with NSCLC are caused by diagnosis at an advanced stage (approximately 70% of patients), which results in a poor prognosis at the late stage that the disease is usually caught [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Lasting Therapeutic Response following Treatment with Pembrolizumab in Patients with Non-Small Cell Lung Cancer: A Real-World Experience

Shalata

Zolnoorian

Migliozzi

et al. 2023

IJMS

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Immune checkpoint inhibitors (ICIs), pembrolizumab in particular, have been shown to be vastly more efficacious than traditional cytotoxic or platinum-based chemotherapies in the treatment of non-small cell lung cancer (NSCLC). While there are plenty of data showing their efficacy and safety profiles, very little exists about the long-term effects of pembrolizumab. We compiled all patients with NSCLC who were treated with pembrolizumab at our institution and had progression-free survival (PFS) of at least 2 years during or after the treatment period. Within this group, we examined the long-term rates of PFS and overall survival (OS), side effect profiles, treatment, and overall disease course up to 60 months after starting treatment. This study included 36 patients with median (range) follow up times from treatment initiation in months as follows: 36 (28–65) overall; 39.5 (28–65) for adenocarcinoma; and 36 (30–58) for squamous cell carcinoma. The median (range) of OS and PFS (months) was comparable for adenocarcinoma, 36 (23–55); and squamous cell carcinoma, 35.5 (28–65). Overall, pembrolizumab shows remarkable long-term safety and efficacy in NSCLC patients. In patients who show an initially strong response and can make it to 24 months of PFS, disease progression after this period seems increasingly unlikely.

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Section: Introductionmentioning

confidence: 99%

Long-Lasting Therapeutic Response following Treatment with Pembrolizumab in Patients with Non-Small Cell Lung Cancer: A Real-World Experience

Shalata

Zolnoorian

Migliozzi

et al. 2023

IJMS

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“…Although gefitinib shows excellent antitumor effects, it was eventually discontinued due to these severe skin toxicities. Erlotinib, a derivative of quinazoline was approved by the FDA on November 18, 2004 for use in NSCLC with exon 19 deletion (del19) or exon 21 point mutation (L858R) ( 66 ). Erlotinib often causes papulopustular exanthemas characterized by pruritus ( 67 ).…”

Section: Egfr Inhibitors Used Clinicallymentioning

confidence: 99%

Mechanism of Lethal Skin Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors and Related Treatment Strategies

Duan

et al. 2022

Front. Oncol.

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Epidermal growth factor receptor (EGFR) inhibitors are widely used to treat various types of cancers such as non-small cell lung cancer, head and neck cancer, breast cancer, pancreatic cancer. Adverse reactions such as skin toxicity, interstitial lung disease, hepatotoxicity, ocular toxicity, hypomagnesemia, stomatitis, and diarrhea may occur during treatment. Because the EGFR signaling pathway is important for maintaining normal physiological skin function. Adverse skin reactions occurred in up to 90% of cancer patients treated with EGFR inhibitors, including common skin toxicities (such as papulopustular exanthemas, paronychia, hair changes) and rare fatal skin toxicities (e.g., Stevens–Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis). This has led to the dose reduction or discontinuation of EGFR inhibitors in the treatment of cancer. Recently, progress has been made about research on the skin toxicity of EGFR inhibitors. Here, we summarize the mechanism of skin toxicity caused by EGFR inhibitors, measures to prevent severe fatal skin toxicity, and provide reference for medical staff how to give care and treatment after adverse skin reactions.

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“…The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become an effective treatment for patients with non-small-cell lung cancer (NSCLC) [ 1 , 2 ]. For patients with NSCLC with EGFR mutations, TKIs have been reported to confer better survival benefits than conventional cytotoxic anticancer therapies [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Concomitant Gastric Acid Suppressants on the Survival of Patients with Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Meta-Analysis

Xia

Zhu

et al. 2022

International Journal of Clinical Practice

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Background. The influence of concomitant use of gastric acid suppressants (AS) on survival of patients with non-small-cell lung cancer (NSCLC) treated with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) is inconsistent according to previous studies. We performed a meta-analysis to evaluate the effect of additional AS in patients with NSCLC taking TKIs. Methods. Relevant observational studies were identified by a search of Medline, Embase, and Web of Science databases. Only studies with multivariate analyses were included. A random-effect model was used to combine the results. Results. Thirteen retrospective studies with 12259 patients were included. Pooled results showed that concomitant use of AS was associated with worse progression-free survival (PFS, adjusted hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.31 to 1.89, P < 0.001 ; I2 = 65%) and overall survival (OS, adjusted HR: 1.38, 95% CI: 1.19 to 1.61, P < 0.001 ; I2 = 70%) in NSCLC patients taking TKIs. Sensitivity analysis limited to studies including NSCLC with EGFR mutation showed consistent results (HR for PFS: 1.53, P = 0.003 ; HR for OS: 1.43, P = 0.001 ). Subgroup analyses indicated that the association between concomitant use of AS and poor survival was not significantly affected by the category of AS used (proton pump inhibitors or histamine type-2 receptor antagonists) or the country of the study (Asian or non-Asian, P for subgroup analysis all >0.05). Conclusions. Concomitant use of AS in patients with NSCLC taking TKIs may be associated with poor survival outcomes.

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Adjuvant Treatment with Tyrosine Kinase Inhibitors in Epidermal Growth Factor Receptor Mutated Non-Small-Cell Lung Carcinoma Patients, Past, Present and Future

Cited by 10 publications

References 28 publications

Long-Lasting Therapeutic Response following Treatment with Pembrolizumab in Patients with Non-Small Cell Lung Cancer: A Real-World Experience

Long-Lasting Therapeutic Response following Treatment with Pembrolizumab in Patients with Non-Small Cell Lung Cancer: A Real-World Experience

Mechanism of Lethal Skin Toxicities Induced by Epidermal Growth Factor Receptor Inhibitors and Related Treatment Strategies

Concomitant Gastric Acid Suppressants on the Survival of Patients with Non-Small-Cell Lung Cancer Treated with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors: A Meta-Analysis

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