Epidermal Growth Factor Receptor Mutation Is Associated With Longer Local Control After Definitive Chemoradiotherapy in Patients With Stage III Nonsquamous Non–Small-Cell Lung Cancer

Yagishita, Shigehiro; Horinouchi, Hidehito; Taniyama, Tomoko; Nakamichi, Shinji; Kitazono, Satoru; Mizugaki, Hidenori; Kanda, Shintaro; Fujiwara, Yutaka; Nokihara, Hiroshi; Yamamoto, Noboru; Sumi, Minako; Shiraishi, Kouya; Kohno, Takashi; Furuta, Koh; Tsuta, Koji; Tamura, Tomohide

doi:10.1016/j.ijrobp.2014.08.344

Cited by 57 publications

(88 citation statements)

References 27 publications

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“…Only one study, Tanaka et al (18), demonstrated that the PFS was shorter and 2-year recurrence-free survival rate was poorer in the EGFR mutant group. Notably, the recurrence patterns in these studies subsequent to cCRT in LA-NSCLC setting were similar to those of the present study, which demonstrated that the EGFR mutant groups exhibited lower loco-regional recurrence rate (15,16,18). Preclinical studies have demonstrated that NSCLC cell lines with EGFR mutations exhibit greater radiosensitivity compared with those without EGFR mutation.…”

Section: Discussionsupporting

confidence: 84%

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Evaluation of concurrent chemoradiotherapy for locally advanced NSCLC according to EGFR mutation status

et al. 2017

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Abstract. Concurrent chemoradiotherapy (cCRT) is the standard treatment for patients with locally advanced non-small cell lung cancer (LA-NSCLC). However, the efficacy and safety of this treatment has not been compared between patients who possess epidermal growth factor receptor (EGFR) mutations and patients with wild-type EGFR. The objective of the present study was to evaluate the effect of the presence of EGFR gene mutations in patients with LA-NSCLC receiving cCRT. Between January 2007 and December 2013, the records of 64 patients were reviewed retrospectively. The data were statistically analyzed to evaluate the efficacy of cCRT according to EGFR mutation status. In total, 15/64 were revealed to possess EGFR mutations, 23%, and comprised the mutant EGFR group. The progression-free survival time was significantly shorter in the mutant EGFR group compared with the patient group with tumors exhibiting wild-type EGFR, 6.3 and 9.5 months, respectively (P<0.001). The overall survival rate was longer in the mutant EGFR group compared with the wild-type EGFR group, although the difference was not statistically significant, 37.1 and 21.1 months, respectively (P=0.26). The disease recurred in all of the patients of the mutant EGFR group, whilst the recurrence rate in the wild-type EGFR group was 89%. The frequency of distant metastasis was significantly higher in the mutant EGFR group compared with the wild-type EGFR group. In conclusion, these data suggest that additional studies are required to identify strategies for reinforcing the efficacy of cCRT, with a focus on the potential use of EGFR tyrosine kinase inhibitors for patients exhibiting an EGFR mutation.

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Section: Discussionsupporting

confidence: 84%

“…patients with LA-NSCLC. Amongst these studies, the majority of groups reported that PFS and recurrence rate were not statistically different (15)(16)(17) between the two groups. In the present study PFS was shorter and recurrence rate was higher in the EGFR mutant group, which was inconsistent with data from previous studies.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of concurrent chemoradiotherapy for locally advanced NSCLC according to EGFR mutation status

et al. 2017

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“…Whether or not the use of EGFR-TKIs combined with RT or chemoradiotherapy proves to be beneficial in unselected populations, data, even if limited, are emerging and their use in patients with tumors harboring EGFR mutations are more likely to benefit from their administration, as in metastatic stage. Prior investigations suggested that patients with locoregionally advanced NSCLC with EGFR mutations had improved locoregional control with RT [54,55]. As indicated in this revision, more recent results demonstrate that patients with EGFR mutations have improved outcomes when treated with combined modality regimens, including EGFR-TKIs [32].…”

Section: Resultsmentioning

confidence: 99%

Radiotherapy of Non-Small-Cell Lung Cancer in the Era of EGFR Gene Mutations and EGF Receptor Tyrosine Kinase Inhibitors

et al. 2015

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Non-small-cell lung cancer (NSCLC) occurs, approximately, in 80-85% of all cases of lung cancer. The majority of patients present locally advanced or metastatic disease when diagnosed, with poor prognosis. The discovery of activating mutations in the EGFR gene has started a new era of personalized treatment for NSCLC patients. To improve the treatment outcome in patients with unresectable NSCLC and, in particular, EGFR mutated, a combined strategy of radiotherapy and medical treatment can be undertaken. In this review we will discuss preclinical data regarding EGF receptor (EGFR) tyrosine kinase inhibitors (TKIs) and radiotherapy, available clinical trials investigating efficacy and toxicity of combined treatment (thoracic or whole brain radiotherapy and EGFR-TKIs) and, also, the role of local radiation in mutated EGFR patients who developed EGFR-TKI resistance.

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“…Although superiority of erlotinib over placebo could not be demonstrated in the setting of adjuvant therapy in patients with completely resected NSCLC (RADIANT trial), there is still much room to investigate the efficacy and safety of targeted agents based on driver oncogenes for obtaining locoregional control (12). Yagishita et al reported that the presence of epidermal growth factor receptor (EGFR) mutation in the tumor was associated with better locoregional control after definitive chemoradiotherapy in patients with Stage III NSCLC (13). Many clinical trials are under way and being planned to introduce EGFR inhibitors (gefitinib and erlotinib) and anaplastic lymphoma kinase inhibitors (ALK inhibitors such as crizotinib and ceritinib) in the treatment of locally advanced NSCLC.…”

Section: Challenges In Systemic Treatmentmentioning

confidence: 99%

“…Recently, the influence of driver oncogenes in patients with locally advanced NSCLC has been studied. For example, the presence of EGFR mutations in the tumor has been reported to be associated with better locoregional control and poor distant control in patients with locally advanced NSCLC (13). A number of trials are in progress to investigate the efficacy of medical treatments, with huge successes in advanced disease settings being obtained with such agents as EGFR-TKIs and immune checkpoint inhibitors in combination with standard chemoradiotherapy.…”

Section: Heterogeneitymentioning

confidence: 99%

Role of multimodality therapy in cIIIA-N2 non–small cell lung cancer: perspective

Horinouchi

2016

Jpn. J. Clin. Oncol.

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Epidermal Growth Factor Receptor Mutation Is Associated With Longer Local Control After Definitive Chemoradiotherapy in Patients With Stage III Nonsquamous Non–Small-Cell Lung Cancer

Cited by 57 publications

References 27 publications

Evaluation of concurrent chemoradiotherapy for locally advanced NSCLC according to EGFR mutation status

Evaluation of concurrent chemoradiotherapy for locally advanced NSCLC according to EGFR mutation status

Radiotherapy of Non-Small-Cell Lung Cancer in the Era of EGFR Gene Mutations and EGF Receptor Tyrosine Kinase Inhibitors

Role of multimodality therapy in cIIIA-N2 non–small cell lung cancer: perspective

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