Concomitant radiotherapy and TKI in metastatic EGFR- or ALK-mutated non-small cell lung cancer: a multicentric analysis on behalf of AIRO lung cancer study group

Borghetti, Paolo; Bonù, Marco Lorenzo; Giubbolini, Rachele; Levra, Niccolò Giaj; Mazzola, Rosario; Perna, Marco; Visani, Luca; Meacci, F.; Taraborrelli, Maria; Triggiani, Luca; Franceschini, Davide; Greco, Carlo; Bruni, Alessio; Magrini, Stefano Maria; Scotti, Vieri

doi:10.1007/s11547-019-00999-w

Cited by 38 publications

(30 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, research on brain metastasis has shown that EGFR-TKIs plus WBRT has a higher response rate and significant improvement in survival, compared with EGFR-TKIs alone in the treatment of BM from EGFR-mutant NSCLC patients [24–27]. Borghetti et al [28] also confirmed that radiation therapy combined with TKI is a safe and well-tolerated therapy for metastatic NSCLC patients with EGFR- or ALK- mutations. In this study, the addition of WBRT to EGFR-TKIs did not lead to any survival benefit in EGFR-mutant LM patients when compared with patients who received only EGFR-TKIs (median OS LM 13.6 vs. 15 months; p = 0.381).…”

Section: Discussionmentioning

confidence: 99%

Whole brain radiation therapy does not improve the overall survival of EGFR-mutant NSCLC patients with leptomeningeal metastasis

Yan

Liu

et al. 2019

Radiat Oncol

View full text Add to dashboard Cite

Background Leptomeningeal metastasis (LM) is a devastating and terminal complication of advanced non-small-cell lung cancer (NSCLC), especially in patients harboring epidermal growth factor receptor (EGFR) mutations. The role of whole brain radiation therapy (WBRT) in the treatment of EGFR-mutant NSCLC patients with LM is not conclusive. Therefore, we conducted a retrospective study to evaluate the therapeutic effect of WBRT in this setting. Methods EGFR-mutant NSCLC patients with LM, who had previously received treatment at the Shandong Cancer Hospital and Institute from July 2014 to March 2018 were reviewed retrospectively. LM was diagnosed by positive CSF cytology and/or leptomeningeal-enhanced magnetic resonance imaging (MRI). Survival was estimated using the Kaplan-Meier method. Results In total, 51 EGFR-mutated NSCLC patients with LM were eligible for analysis, subdivided into 26 in the WBRT group and 25 in the non-WBRT group. No significant differences were observed in intracranial ORR (15.4% vs. 16%, p = 0.952) and DCR (34.7% vs. 28%, p = 0.611) between the two groups. The median iPFSLM and OSLM for the entire cohort were 3.3 months (95% CI: 2.77–3.83) and 12.6 months (95% CI: 9.66–15.54), respectively. No difference in iPFSLM was observed between the WBRT and non-WBRT groups (median 3.9 vs. 2.8 months; HR = 0.506, p = 0.052). The median OSLM was 13.6 months in the WBRT group, compared with 5.7 months in the non-WBRT group (HR = 0.454, p = 0.022). Multivariate analyses of OSLM showed that KPS ≥ 80 at the time of LM diagnosis (HR = 0.428, 95% CI: 0.19–0.94; p = 0.034) and the administration of EGFR-TKIs (HR = 0.258, 95% CI: 0.11–0.58; p = 0.001) were independent predictors of survival, but WBRT (HR = 0.49, 95% CI: 0.24–1.01; p = 0.54) was not. Toxicities associated with WBRT or other treatment were rare. Conclusion For EGFR-mutated NSCLC patients with LM, WBRT did not improve intracranial treatment response and survival statistically.

show abstract

Section: Discussionmentioning

confidence: 99%

Whole brain radiation therapy does not improve the overall survival of EGFR-mutant NSCLC patients with leptomeningeal metastasis

Yan

Liu

et al. 2019

Radiat Oncol

View full text Add to dashboard Cite

show abstract

“…Sites of RT were brain, bone, lung or others in 46, 27, 14 and 13%, respectively. OS at 1 and 2 years in oligometastatic/oligoprogressive patients were 79 and 61.8%, respectively [25].…”

Section: Target Therapy and High Doses Rtmentioning

confidence: 98%

Oligometastasis and local ablation in the era of systemic targeted and immunotherapy

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: During these last years, new agents have dramatically improved the survival of the metastatic patients. Oligometastases represent a continuous field of interest in which the integration of metastases-directed therapy and drugs could further improve the oncologic outcomes. Herein a narrative review is performed regarding the main rationale in combining immunotherapy and target therapies with SBRT looking at the available clinical data in case of oligometastatic NSCLC, Melanoma and Kidney cancer. Material and method: Narrative Review regarding retrospective and prospective studies published between January 2009 to November 2019 with at least 20 patients analyzed. Results: Concerning the combination between SBRT and Immunotherapy, the correct sequence of remains uncertain, and seems to be drug-dependent. The optimal patients' selection is crucial to expect substantial benefits to SBRT/ Immunotherapy combination and, among several factors. A potential field of interest is represented by the so-called oligoprogressed disease, in which SBRT could improve the long-term efficacy of the existing target therapy. Conclusions: A low tumor burden seems to be the most relevant, thus making the oligometastatic disease represent the ideal setting for the use of combination therapies with immunological drugs.

show abstract

“…No unexpected toxicities were observed. A large retrospective series using TKIs with RT in oligoprogressive ALK-positive and EGFR-positive NSCLC showed impressive two-year OS of 62% (86).…”

Section: Clinical Data On Targeted Agents and Radiotherapy Combinations In Oligoprogressive Oncogene-addicted Nsclcmentioning

confidence: 99%

Combining radiotherapy with targeted therapies in non-small cell lung cancer: focus on anti-EGFR, anti-ALK and anti-angiogenic agents

Wrona¹,

Dziadziuszko²,

Jassem³

2021

Transl Lung Cancer Res

View full text Add to dashboard Cite

These include monoclonal antibodies targeting specific antigens on the tumor cell surface, and small molecule tyrosine kinase inhibitors (TKI) acting intracellularly. Both groups of compounds interfere with crucial cellular signaling pathways involved in tumor cell growth and cancer progression. Activating epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements (occurring almost exclusively in lung Review Article on Radiotherapy in Thoracic Malignancies

show abstract

Concomitant radiotherapy and TKI in metastatic EGFR- or ALK-mutated non-small cell lung cancer: a multicentric analysis on behalf of AIRO lung cancer study group

Cited by 38 publications

References 22 publications

Whole brain radiation therapy does not improve the overall survival of EGFR-mutant NSCLC patients with leptomeningeal metastasis

Whole brain radiation therapy does not improve the overall survival of EGFR-mutant NSCLC patients with leptomeningeal metastasis

Oligometastasis and local ablation in the era of systemic targeted and immunotherapy

Combining radiotherapy with targeted therapies in non-small cell lung cancer: focus on anti-EGFR, anti-ALK and anti-angiogenic agents

Contact Info

Product

Resources

About