The effect of <scp>EGFR‐TKIs</scp> on survival in advanced non‐small‐cell lung cancer with <scp>EGFR</scp> mutations: A real‐world study

Yu, Xiaoqing; Si, Jinfei; Wei, Jingwen; Wang, Yanling; Sun, Yan; Jin, Jiyuan; Zhang, Xiaoyan; Ma, Tonghui; Song, Zhengbo

doi:10.1002/cam4.5413

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…25 Yu, et al (2023) also reported different results where the median OS in exon 19 del mutations was better than exon 21 L858R with a very significant difference (mOS 32.4 vs. 24.83, p = 0.0013). 26 As previously explained, the OS and PFS curves based on the EGFR common mutation type intersect, meaning there was no significant relationship between both types. The Proportional Hazard assumption was not met, meaning that the survival rate and PFS ratio between the two types of mutations were not constant.…”

Section: Discussionmentioning

confidence: 87%

Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment

Prasetyo

Soeroso

Tarigan

et al. 2023

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Introduction: Patients with adenocarcinoma of the lung that have a common EGFR mutation, the Exon 19 Del mutation, survive better than those with the Exon 21 L858R mutation. This study examined whether there is a significant difference in prognosis between two common EGFR mutations, namely exon 19 Del and 21 L858R. This study compared OS (overall survival) and PFS (progression-free survival) in NSCLC patients with Exon 19 Del and Exon 21 L858R mutations who received EGFR-TKI targeted therapy at H. Adam Malik Hospital Medan. Methods: This analysis study used a retrospective cohort design to evaluate the OS and PFS of NSCLC patients who underwent EGFR-TKI precision medicine at H. Adam Hospital Malik Medan between January 1, 2017, and December 31, 2020 and also had Exon 19 Del and Exon 21 L858R alterations. Results: A total of 88 people were sampled. The majority of research subjects were male (60.2%). Median OS was eleven months (95 percent CI:9.594-12,406). According to the study's data, eight people (9.1%) survived until the study's ending. The median OS of Exon 19 Del Common Mutation was 11 months (95%CI 9,064-12,936). While Exon 21 L858R group had ten months (95%CI 4,546-15,454). The log-rank test identified no statistical difference in median OS between mutation types (p=0.562). Conclusion: The findings of this study revealed that subjects with Exon 19 Del mutations had a longer median OS and PFS than those with Exon 21 L858R variants. Nevertheless, there was no significant difference in median OS and PFS between study subjects with mutation of Exon 19 Del and Exon 21 L858R, which received the targeted medication.

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Section: Discussionmentioning

confidence: 87%

Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment

Prasetyo

Soeroso

Tarigan

et al. 2023

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“…These findings are consistent with similar studies which reported longer overall survival in subjects with EGFR Exon 20 T790M mutations who received EGFR-TKI treatment compared to those without the mutation and without EGFR-TKI treatment. (27) There are some limitations of the current study. To overcome these limitations and gain a deeper understanding of the clinical outcomes and prognosis associated with the EGFR Exon 20 T790M, a multi-center study with a larger sample size is recommended.…”

Section: Discussionmentioning

confidence: 88%

Osimertinib as a Potential Targeted Therapy for Non-Small Cell Lung Carcinoma (NSCLC) Patients with EGFR Exon 20 T790M

Zam,

Iskandar,

Tabri

et al. 2023

Indones Biomed J

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BACKGROUND: Emergence of drug resistance due to epidermal growth factor receptor (EGFR) Exon 20 T790M poses a challenge in the effective management of non-small cell lung carcinoma (NSCLC). Significant breakthrough in the management of NSCLC with a specific genetic alteration causes substantial condition improvement in patients whose cancer progressed after first-generation tyrosine kinase inhibitor treatment and who developed tumors with EGFR Exon 20 T790M mutation. The present study analyzed a cohort of NSCLC patients and investigated the incidence of the EGFR Exon 20 T790M status with Osimertinib therapy, along with its impact on survival rates.METHODS: This was a retrospective cohort study on 22 NSCLC subjects who were genetically examined for EGFR status from plasmic cell free total nucleic acid. Subjects with EGFR Exon 20 T790M mutation were treated with/without Osimertinib. Demographic and clinical data were descriptively summarized, and the differences of each variable and correlation between survival rate and EGFR Exon 20 T790M were analyzed.RESULTS: Subjects with (n=13) and without (n=9) EGFR Exon 20 T790M had survival rates of 10.77±2.45 and 4.78±1.48, respectively (p=0.000). Based on 1-year survival status of subjects with EGFR Exon 20 T790M, there were 3 Osimertinib-treated survivors and 2 Osimertinib-treated non-survivors. Eight subjects with EGFR Exon 20 T790M and without Osimertinib treatment did not survive (p=0.001).CONCLUSION: Since the treatment of Osimertinib demonstrated a noteworthy survival rate among NSCLC subjects with EGFR Exon 20 T790M, thus Osimertinib could be suggested as a potential targeted therapy for NSCLC subjects with EGFR Exon 20 T790M.KEYWORDS: non-small cell lung carcinoma, EGFR, Exon 20, T790M, osimertinib

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“…Systemic treatment for stage IV NSCLC has entered the era of precision therapy, including chemotherapy, 8 targeted therapy, 9 and immunotherapy 10,11 . Tyrosine kinase inhibitors (TKIs) can achieve an excellent therapeutic response in NSCLC with positive mutations in driver Genes and significantly improve progression‐free survival (PFS) 12–15 .…”

Section: Introductionmentioning

confidence: 99%

Impact of thoracic tumor radiotherapy on survival in non‐small‐cell lung cancer with malignant pleural effusion treated with targeted therapy: Propensity score matching study

Li,

Hu,

et al. 2023

Cancer Medicine

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BackgroundEGFR‐mutant (EGFR‐M) and ALK‐positive (ALK‐P)are common in malignant pleural effusion (MPE) with metastatic non‐small‐cell lung cancer (NSCLC) (MPE‐NSCLC). The impact of thoracic tumor radiotherapy on survival in such patients remains unclear. We aimed to investigate whether thoracic tumor radiotherapy could improve overall survival (OS) in such patients.MethodsAccording to whether or not patients accepted thoracic tumor radiotherapy, 148 patients with EGFR‐M or ALK‐P MPE‐NSCLC treated with targeted therapy were classified into two groups: DT group without thoracic tumor radiotherapy and DRT group with thoracic tumor radiotherapy. Propensity score matching (PSM) was performed to balance clinical baseline characteristics. Overall survival was analyzed by Kaplan–Meier, compared by log‐rank test, and evaluated using Cox proportional hazards model.ResultsMedian survival time (MST) was 25 months versus 17 months in the DRT group and DT group. The OS rates at 1, 2, 3, 5 years in the DRT group and DT group were 75.0%, 52.8%, 26.8%, 11.1% and 64.5%, 28.4%, 9.2%, 1.8%, respectively (χ2 = 12.028, p = 0.001). Compared with DT group, the DRT group still had better survival after PSM (p = 0.007). Before and after PSM, factors associated with better OS through multivariable analysis were that thoracic tumor radiotherapy, radiotherapy, N0‐2, and ALK‐TKIs. Grades 4–5 radiation toxicities were not observed in patients; 8 (11.6%) and 7 (10.1%) out of the DRT group suffered from Grade 3 radiation esophagitis and radiation pneumonitis, respectively.ConclusionOur results for EGFR‐M or ALK‐P MPE‐NSCLC showed that thoracic tumor radiotherapy may be crucial factor in improving OS with acceptable toxicities. Potential biases should not be neglected: Further randomized controlled trials are necessary to confirm this result.

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The effect of EGFR‐TKIs on survival in advanced non‐small‐cell lung cancer with EGFR mutations: A real‐world study

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 6 publications

References 40 publications

Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment

Survival Analysis of Lung Adenocarcinoma Patients with Exon 19 Del and 21 L858R Mutations Receiving EGFR-TKI Treatment

Osimertinib as a Potential Targeted Therapy for Non-Small Cell Lung Carcinoma (NSCLC) Patients with EGFR Exon 20 T790M

Impact of thoracic tumor radiotherapy on survival in non‐small‐cell lung cancer with malignant pleural effusion treated with targeted therapy: Propensity score matching study

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