First-line erlotinib versus gemcitabine/cisplatin in patients with advanced EGFR mutation-positive non-small-cell lung cancer: analyses from the phase III, randomized, open-label, ENSURE study

Wu, Yi‐Long; Zhou, Caicun; Liam, Chong Kin; Wu, Gang; Liu, X.; Zhong, Zhaoyang; Lü, Shun; Cheng, Ying; Han, Baohui; Chen, L.; Huang, Cheng; Qin, Shanshan; Zhu, Yixiang; Pan, Hong; Liang, Houjie; Li, E.; Jiang, Guo Liang; How, Soon Hin; Fernando, Mitchel; Zhang, Y.; Xia, Fan; Zuo, Yunxia

doi:10.1093/annonc/mdv270

Cited by 668 publications

(522 citation statements)

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“…Based on results from seven prospective phase III randomized trials comparingfirst-line epidermal growthfactor receptor(EGFR) tyrosine kinase inhibitors (TKIs) to platinum-doublet chemotherapy as first-line treatment of non-small cell lung cancer (NSCLC) patients harboring activating EGFR mutations (EGFRm), it is now well-established that EGFR TKI offers superior improvement in progression-free survival (PFS) [1][2][3][4][5][6][7]. Exploratory univariate analyses of three of the seven clinical trials (WJTOG3405, EURTAC, and LUX-Lung-3 [LL3]) suggested that EGFRm NSCLC patients who had a previous smoking history (former or current smoker) did not seem to derive a statistical PFS improvement when EGFR TKI was compared with platinum-doublet chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

“…The HR for PFS among former/current smokers in OPTIMAL was 0.21 (95% CI: 0.09-0.49) [3]. The HR for PFS among current or ex smokers in LL6 was 0.46 (95% CI: 0.22-1.00) [6].Two remaining trials (NEJ002 and ENSURE) have not reported univariate analysis by smoking status [2,7]. Given that up to one-third of EGFRm patients had a previous smoking history [8], we performed a meta-analysis to analyze the role of smoking status and other potential predictive factors that may influence clinical outcome in EGFRm patients receiving firstline EGFR TKIs.…”

Section: Introductionmentioning

confidence: 99%

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The Role of Smoking Status on the Progression-Free Survival of Non-Small Cell Lung Cancer Patients Harboring Activating Epidermal Growth Factor Receptor (EGFR) Mutations Receiving First-Line EGFR Tyrosine Kinase Inhibitor Versus Platinum Doublet Chemotherapy: A Meta-Analysis of Prospective Randomized Trials

et al. 2015

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Background. Univariate analyses from several randomized phase III trials seemed to suggest ever-smokers with advanced mutated epidermal growth factor receptor (EGFRm) non-small cell lung cancer (NSCLC) did not seem to benefit from EGFR tyrosine kinase inhibitors (TKIs) as first-line treatment when compared with platinum-doublet chemotherapy as measured by progression-free survival (PFS). Methods. A literature-based meta-analysis of PFS outcomes as measured by log-transformed pooled hazard ratio (HR) was performed using a random-effect model. Pooled HRs for smoking status, age, gender, ethnicity, type of EGFR mutation, and EGFR TKI were obtained. Comparison of the pooled HR was performed by metaregression analysis. Results. Among the 1,649 EGFRm NSCLC patients analyzed from 7 prospective randomized trials (WJTOG3405, NEJ002, EURTAC, OPTIMAL, LUX Lung-3, LUX Lung-6, and ENSURE),

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Role of Smoking Status on the Progression-Free Survival of Non-Small Cell Lung Cancer Patients Harboring Activating Epidermal Growth Factor Receptor (EGFR) Mutations Receiving First-Line EGFR Tyrosine Kinase Inhibitor Versus Platinum Doublet Chemotherapy: A Meta-Analysis of Prospective Randomized Trials

et al. 2015

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“…[17] The use of ctDNA has been successfully shown to predict the clinical benefit of erlotinib in patients with EGFR mutations detected on ctDNA leading to its FDA approval using the companion COBAS EGFR mutation test v2. [18,19] Difficult to diagnose cancers Inaccessible tumors such as deep pelvic, pancreatic, and bone tumors can be diagnosed with CTCs or ctDNA. There are case reports where synchronous versus metastatic malignancies have been identified by detecting different set of specific mutation.…”

Section: Taking Therapeutic Decisions Based On Liquid Biopsymentioning

confidence: 99%

Liquid biopsy, an innovation of modern medicine

Gujree

Singh

2017

Int J Mol Immuno Oncol.

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<div id="nav"><div id="og_head"><div id="og_q"><div class="og_h"><div class="og_m">Biopsies have been the best tool in the hands of the clinicians for the appropriate management of malignancies including diagnosis, prognosis and reassessment. They are and have been the gold standard in their diagnosis. Due to certain unavoidable limitations of needle biopsy, there is emergence of a new biomarker in oncology called LIQUID BIOPSY: Analysis of circulating tumour cells (CTC) and circulating free tumor DNA (ctDNA) from the peripheral blood. As this technology evolves it may prove to be a critical component of personalized medicine in this modern era of diagnostics. Liquid biopsy has a great potential in cancer diagnosis, monitoring and predicting survival. Nevertheless false positive results exist. The major challenge with this technology is assay sensitivity and specificity. This mini-review tries to fill the gap between reality and our hope of this “liquid biopsy”.</div></div></div></div></div>

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“…Patients with NSCLC with IIIB and IV have particularly poor prognoses. In the last decade, the me-dian overall survival of the patients with metastatic NSCLC treated systemically within clinical studies, have grown from a few months to more than 20 months as reported in some studies results [4][5][6][7]. This improvement was obtained thanks not only to the modification of the previous treatment regimens [8][9][10][11], but first of all thanks to the application of new drugs, such as epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) and ALK inhibitors [12][13][14][15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

The results of first line systemic therapy of NSCLC in clinical practice

Adamowicz¹

2017

Nowotwory. Journal of Oncology

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Introduction. Lung cancer is the most common cancer in the world. Every year, there are over 1.4 million new cases and about 1.3 million deaths due to lung cancer. Data on the results of palliative treatment of patients with non-small cell lung cancer in Poland are scarce. Methods. The results of first-line palliative chemotherapy in 204 lung cancer patients treated in the period 2011-2014 in two cancer centres were analysed. Results. The mean age of the study group was 63.4 ± 8.3 years; 155 patients received chemotherapy with cisplatin, 33 -schemes containing carboplatin, 8 -inhibitors of EGFR tyrosine kinase, 8 -vinorelbine or gemcitabine monotherapy. Complete regression was observed in 2 patients, partial response -in 52 patients (25%), stable disease in 92 (45%) and 58 (28%) patients had progression. Median survival for the entire group of patients was 12 months. Multidrug chemotherapy with cisplatin compared with chemotherapy involving carboplatin monotherapy was associated with increased toxicity in total (p = 0.04). An increased toxicity concerned only to haematological complications and renal insufficiency expressed by the level of creatinine in blood serum. There was no apparent effect of chemotherapy on the overall quality of life. Conclusions. The results of palliative treatment of non-small cell lung cancer in daily practice are comparable to those obtained in prospective clinical trials despite having a different population of treated patients. The use of palliative chemotherapy had no significant effect on quality of life. NOWOTWORY J Oncol 2017; 67, 1: 24-33

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First-line erlotinib versus gemcitabine/cisplatin in patients with advanced EGFR mutation-positive non-small-cell lung cancer: analyses from the phase III, randomized, open-label, ENSURE study

Abstract: These analyses demonstrate that first-line erlotinib provides a statistically significant improvement in PFS versus GP in Asian patients with EGFR mutation-positive NSCLC (NCT01342965).

Cited by 668 publications

References 18 publications

Liquid biopsy, an innovation of modern medicine

The results of first line systemic therapy of NSCLC in clinical practice

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