Presence of pleural effusion is associated with a poor prognosis in patients with epidermal growth factor receptor-mutated lung cancer receiving tyrosine kinase inhibitors as first-line treatment

Wang, Tso Fu; Chu, Sung Chao; Lee, Jen Jyh; Yang, Gee Gwo; Huang, Wei Han; Chang, En Ting; Low, Tissot; Wu, Yi Feng; Kao, Ruey Ho; Lin, Chih Bin

doi:10.1111/ajco.12658

Cited by 13 publications

(12 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies discussed the efficacy of EGFR TKIs in EGFR -mutated NSCLC patients with pleural effusion [ 24 ]; the results reveal that the response rate was only slightly lower than that observed in previous prospective randomized trials, in which treatment duration with gefitinib was considerably shorter. This is consistent with our findings of similar TKI response rates in patients with EGFR -mutated pleural effusion, although they show a shorter PFS than other patients with EGFR mutation examined in previous studies.…”

Section: Discussionmentioning

confidence: 73%

EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors

et al. 2018

View full text Add to dashboard Cite

PurposeMalignant pleural effusions (MPEs) are often observed in lung cancer, particularly adenocarcinoma. The aim of this study was to investigate epidermal growth factor receptor (EGFR) mutation status in lung adenocarcinoma-associated MPEs (LA-MPEs) and its correlation with efficacy of EGFR tyrosine kinase inhibitor (TKI) therapy.Materials and MethodsSamples comprised 40 cell blocks of pathologically-confirmed LA-MPEs collected before the start of EGFR TKI therapy. EGFR mutation status was re-evaluated by peptide nucleic acid clamping and the clinical outcomes of EGFR TKI‒treated patients were analyzed retrospectively.ResultsEGFR mutations were detected in 72.5% of LA-MPE cell blocks (29/40). The median progression-free survival for patients with EGFR mutations in LA-MPEs was better than that for patients with wild-type EGFR (7.33 months vs. 2.07 months; hazard ratio, 0.486; 95% confidence interval, 0.206 to 1.144; p=0.032). The objective response rate (ORR) of 26 patients with EGFR mutations in LA-MPEs among the 36 patients with measurable lesions was 80.8%, while the ORR of the 10 patients with wild-type EGFR in LA-MPEs was 10% (p < 0.001). Among the 26 patients with EGFR mutations in LA-MPEs, the ORR of target lesions and LA-MPEs were 88.5% and 61.5%, respectively (p=0.026).ConclusionEGFR mutation status in cell blocks of LA-MPEs confirmed by pathologic diagnosis is highly predictive of EGFR TKI efficacy. For patients with EGFR mutations in LA-MPEs, the response to EGFR TKIs seems to be worse for pleural effusions than for solid tumors.

show abstract

Section: Discussionmentioning

confidence: 73%

EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Correspondingly, previous reports showed that the presence of pleural effusion was a significant poor prognosis factor in EGFR-mutant NSCLC patients. 14,15 Pleural effusion was reported to be formed through vascular endothelial growth factor (VEGF) activity, which is associated with vascular hyperpermeability. [16][17][18] In addition, the overexpression of VEGF receptors in tumors reduces the sensitivity to EGFR-TKI.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of pleural effusion in EGFR‐mutant non‐small cell lung cancer patients without brain metastasis

et al. 2019

View full text Add to dashboard Cite

Background In epidermal growth factor receptor ( EGFR )‐mutant non‐small cell lung cancer (NSCLC), brain metastasis is known as a poor prognosis factor. However, prognostic factors in the patients without brain metastasis remain unclear. In this study, we aimed to clarify the differences between metastatic site and prognosis in common EGFR ‐mutant NSCLC patients without brain metastasis. Methods Chemotherapy‐naïve, advanced EGFR ‐mutant NSCLC patients without brain metastasis diagnosed between January 2010 and March 2016 were enrolled. We evaluated prognosis according to the presence or absence of bone metastases, liver metastasis, and pleural effusion. Results A total of 50 EGFR ‐mutant NSCLC patients without brain metastasis were enrolled. The median progression‐free survival and overall survival were significantly shorter in patients with pleural effusion than in those patients without (progression‐free survival 7.0 months, 95% confidence interval [CI] 3.7–13.0 vs. 13.0 months, 95% CI 9.1–21.7, hazard ratio [HR] 2.29, 95% CI 1.11–4.73, P = 0.020; overall survival 19.5 months, 95% CI 5.7–28.8 vs. 55.3 months, 95% CI 24.0–not evaluable, HR 3.00, 95% CI 1.35–6.68, P = 0.005). Pleural effusion was an independent factor of poor prognosis for progression‐free survival (HR 3.44, 95% CI 1.50–7.88, P = 0.003) and overall survival (HR 2.34, 95% CI 1.00–5.44, P = 0.049). Conclusion Pleural effusion might be a poor prognosis factor for advanced EGFR ‐mutant NSCLC patients without brain metastasis treated with first‐generation EGFR‐tyrosine kinase inhibitors. Further precision medicine according to the metastatic site is required.

show abstract

“…Mutational analysis of EGFR gene was done as described in a previous study. [ 18 ] Briefly, formalin-fixed, paraffin-embedded tissues were used. An EGFR RGQ Kit (Qiagen, Hilden, Germany) was used for the analysis of mutations in EGFR, which utilizes amplification refractory mutation-specific polymerase chain reaction and Scorpion technologies for detection and direct sequencing.…”

Section: Methodsmentioning

confidence: 99%

Lymphocyte percentage and platelet count correlate with the treatment outcome to tyrosine kinase inhibitors in epidermal growth factor receptor–mutated lung adenocarcinoma

Li¹,

Lin

Chu³

et al. 2020

Medicine

Self Cite

View full text Add to dashboard Cite

This observational study evaluated the treatment outcomes of clinical factors on the patients with lung adenocarcinoma with epidermal growth factor receptor mutations who received tyrosine kinase inhibitors as first-line treatment. Patients with stage IIIb or IV lung adenocarcinoma with mutated epidermal growth factor receptor were enrolled retrospectively between March 2010 and December 2017. The hematologic markers on progression-free survival (PFS) and overall survival (OS) were analyzed. Totally 190 patients were enrolled. In univariate analysis by hematologic markers, lower lymphocyte percentage and higher platelet count were associated with significantly poor PFS and OS. Multivariate analysis showed lower lymphocyte percentage was independent poor prognostic factors for PFS and OS. Higher platelet count was an independent poor prognostic factor for OS only. Patients with lung adenocarcinoma receiving tyrosine kinase inhibitors with lower lymphocyte percentage and higher platelet count had poorer prognoses compared with other patients.

show abstract

Presence of pleural effusion is associated with a poor prognosis in patients with epidermal growth factor receptor-mutated lung cancer receiving tyrosine kinase inhibitors as first-line treatment

Abstract: The presence of pleural effusion predicts poor PFS and OS in lung adenocarcinoma patients receiving TKIs as the first-line treatment. Additional studies are warranted to elucidate the underlying mechanisms and determine novel strategies for improving the outcome of these patients.

Cited by 13 publications

References 44 publications

EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors

EGFR Mutation Status in Lung Adenocarcinoma-Associated Malignant Pleural Effusion and Efficacy of EGFR Tyrosine Kinase Inhibitors

Prognostic impact of pleural effusion in EGFR‐mutant non‐small cell lung cancer patients without brain metastasis

Lymphocyte percentage and platelet count correlate with the treatment outcome to tyrosine kinase inhibitors in epidermal growth factor receptor–mutated lung adenocarcinoma

Contact Info

Product

Resources

About