Health-Related Quality-of-Life in a Randomized Phase III First-Line Study of Gefitinib Versus Carboplatin/Paclitaxel in Clinically Selected Patients from Asia with Advanced NSCLC (IPASS)

Thongprasert, Sumitra; Duffield, Emma; Saijo, Nagahiro; Wu, Yi‐Long; Yang, James Chih‐Hsin; Chu, Da Tong; Liao, Meilin; Chen, Yuh Min; Kuo, Han Pin; Negoro, Shunichi; Lam, Kwok Chi; Armour, Alison; Magill, Patrick; Fukuoka, Masahiro

doi:10.1097/jto.0b013e31822adaf7

Cited by 122 publications

(64 citation statements)

References 17 publications

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“…As to their report, the response rates were 64.7% and 81.3% and the timeto-partial response were 40 and 20 days respectively, with evaluation limited to patients with a response. Other studies have also reported that the median time to symptomatic relief was observed within 2-3 weeks for patients treated with EGFR TKIs (18,19). These results suggest that TKI can be considered as the first choice if the primary goal was to achieve prompt symptomatic relief.…”

Section: Palliative Radiotherapy In Advanced Nsclc Treated With Egfr Tkisupporting

confidence: 49%

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Xia

Zhang

2017

J. Thorac. Dis.

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In recent years, the treatment of advanced non-small cell lung cancer (NSCLC) was greatly promoted by the discovery of oncogenic drivers and the development of targeted therapies specific for these drivers. Somatic mutations in epidermal growth factor receptor (EGFR) are the most common type in patients with NSCLC. Small-molecule tyrosine kinase inhibitor (TKI) targeting EGFR produced relatively high response rate and long duration with acceptable toxicity profile. Also, the life expectancy in patients with active EGFR mutation has been significantly prolonged than the past. Additionally, evolution of advanced imaging and radiation techniques has expanded the indications for radiotherapy in complex clinical situation. All of those factors contributed to the widely use of radiotherapy for advanced NSCLC treated with TKI therapy. In this review, we will discuss how to integrate radiotherapy into the comprehensive treatment of patients with TKI therapy in order to maximize the therapeutics effect.

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Section: Palliative Radiotherapy In Advanced Nsclc Treated With Egfr Tkisupporting

confidence: 49%

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Xia

Zhang

2017

J. Thorac. Dis.

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“…In the BR.21 study using unselected patients, another EGFR TKI, erlotinib, also improved tumor-related symptoms and important aspects of QoL such as physical functioning [28]. Post hoc investigations in the IPASS study employing selection by background indicated that QoL was better in the gefitinib group than in the chemotherapy group for patients with EGFRmutated NSCLC [29]. Taken together with our first prospective QoL analysis of patients with EGFR-mutated NSCLC, EGFR TKI therapy provides an advantage in terms of improving QoL and symptoms over conventional cytotoxic agents.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life with Gefitinib in Patients with EGFR-Mutated Non-Small Cell Lung Cancer: Quality of Life Analysis of North East Japan Study Group 002 Trial

et al. 2012

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Background. For non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations, first-line gefitinib produced a longer progressionfree survival interval than first-line carboplatin plus paclitaxel but did not show any survival advantage in the North East Japan 002 study. This report describes the quality of life (QoL) analysis of that study.Methods. Chemotherapy-naïve patients with sensitive EGFR-mutated, advanced NSCLC were randomized to receive gefitinib or chemotherapy (carboplatin and paclitaxel). Patient QoL was assessed weekly using the Care Notebook, and the primary endpoint of the QoL analysis

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“…Compared with cytotoxic treatment, TKI toxicity profiles are mild and treatment results in a benefit with respect to progression-free survival. Consequently, in this subgroup of patients with an activating EGFR mutation, quality of life is improved with TKI treatment compared with cytotoxic chemotherapy (7).…”

mentioning

confidence: 99%

Assessment of Simplified Methods to Measure ¹⁸F-FLT Uptake Changes in EGFR-Mutated Non–Small Cell Lung Cancer Patients Undergoing EGFR Tyrosine Kinase Inhibitor Treatment

et al. 2014

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3′-deoxy-3′-18 F-fluorothymidine ( 18 F-FLT) PET/CT provides a noninvasive assessment of proliferation and, as such, could be a valuable imaging biomarker in oncology. The aim of the present study was to assess the validity of simplified quantitative parameters of 18 F-FLT uptake in non-small cell lung cancer (NSCLC) patients before and after the start of treatment with a tyrosine kinase inhibitor (TKI). Methods: Ten patients with metastatic NSCLC harboring an activating epidermal growth factor receptor mutation were included in this prospective observational study. Patients underwent 15 O-H 2 O and 18 F-FLT PET/CT scanning on 3 separate occasions: within 7 d before treatment, and 7 and 28 d after the first therapeutic dose of a TKI (gefitinib or erlotinib). Dynamic scans were acquired and venous blood samples were collected during the 18 F-FLT scan to measure parent fraction and plasma and whole-blood radioactivity concentrations. Simplified measures (standardized uptake value [SUV] and tumor-to-blood ratio [TBR]) were correlated with fully quantitative measures derived from kinetic modeling. Results: Twenty-nine of thirty 18 F-FLT PET/CT scans were evaluable. According to the Akaike criterion, a reversible 2-tissue model with 4 rate constants and blood volume parameter was preferred in 84% of cases. Relative therapy-induced changes in SUV and TBR correlated with those derived from kinetic analyses (r 2 5 0.83-0.97, P , 0.001, slope 5 0.72-1.12). 18 F-FLT uptake significantly decreased at 7 and 28 d after the start of treatment compared with baseline (P , 0.01). Changes in 18 F-FLT uptake were not correlated with changes in perfusion, as measured using 15 O-H 2 O. Conclusion: SUV and TBR could both be used as surrogate simplified measures to assess changes in 18 F-FLT uptake in NSCLC patients treated with a TKI, at the cost of a small underestimation in uptake changes or the need for a blood sample and metabolite measurement, respectively.

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Health-Related Quality-of-Life in a Randomized Phase III First-Line Study of Gefitinib Versus Carboplatin/Paclitaxel in Clinically Selected Patients from Asia with Advanced NSCLC (IPASS)

Abstract: HRQoL and symptom endpoints were consistent with efficacy outcomes in IPASS and favored gefitinib in patients with EGFR mutation-positive tumors and carboplatin/paclitaxel in patients with EGFR mutation-negative tumors.

Cited by 122 publications

References 17 publications

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Quality of Life with Gefitinib in Patients with EGFR-Mutated Non-Small Cell Lung Cancer: Quality of Life Analysis of North East Japan Study Group 002 Trial

Assessment of Simplified Methods to Measure ¹⁸F-FLT Uptake Changes in EGFR-Mutated Non–Small Cell Lung Cancer Patients Undergoing EGFR Tyrosine Kinase Inhibitor Treatment

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Health-Related Quality-of-Life in a Randomized Phase III First-Line Study of Gefitinib Versus Carboplatin/Paclitaxel in Clinically Selected Patients from Asia with Advanced NSCLC (IPASS)

Abstract: HRQoL and symptom endpoints were consistent with efficacy outcomes in IPASS and favored gefitinib in patients with EGFR mutation-positive tumors and carboplatin/paclitaxel in patients with EGFR mutation-negative tumors.

Cited by 122 publications

References 17 publications

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Quality of Life with Gefitinib in Patients with EGFR-Mutated Non-Small Cell Lung Cancer: Quality of Life Analysis of North East Japan Study Group 002 Trial

Assessment of Simplified Methods to Measure 18F-FLT Uptake Changes in EGFR-Mutated Non–Small Cell Lung Cancer Patients Undergoing EGFR Tyrosine Kinase Inhibitor Treatment

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Assessment of Simplified Methods to Measure ¹⁸F-FLT Uptake Changes in EGFR-Mutated Non–Small Cell Lung Cancer Patients Undergoing EGFR Tyrosine Kinase Inhibitor Treatment