Xiaoke Liu1, Lingzhi Hong2, Monique Nilsson2, Shawna Marie Hubert2, Shuhong Wu3, Waree Rinsurongkawong4, Jeffery Lewis4, Amy Spelman2, Jack Roth3, Steven Swisher3, Yong He5, J Jack Lee4, Bingliang Fang3, John V Heymach2, Jianjun Zhang6, Xiuning Le7. 1. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, USA; Department of Thoracic Oncology, Cancer Center, West China Hospital, West China Medical School, Sichuan University, USA. 2. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, USA. 3. Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, USA. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, USA. 5. Daping Hospital and Research Institute of Surgery, Third Military Medical University, USA. 6. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, USA. Electronic address: jzhang20@mdanderson.org. 7. Department of Thoracic/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, USA. Electronic address: xle1@mdanderson.org.
Abstract
BACKGROUND: Osimertinib is the treatment of choice for advanced EGFR-mutant non-small cell lung cancer (NSCLC). However, novel strategies to improve the duration of disease control are still urgently needed. Aspirin has been shown to decrease cancer incidence and improve outcomes in various malignancies. Therefore, we evaluated a cohort of patients who received osimertinib with or without concurrent use of aspirin to assess whether the addition of aspirin may lead to improved clinical outcomes. METHODS: MD Anderson Cancer Center GEMINI database was retrospectively queried for EGFR-mutant NSCLC patients who received osimertinib with or without concurrent use of aspirin for progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 365 patients were identified including 77 which had concurrent use of aspirin. Patients in the aspirin-osimertinib group had significantly improved PFS (21.3 vs 11.6 months; HR, 0.52; 95 % CI, 0.38-0.70) and OS (Not reached vs 32.3 months; HR, 0.56; 95 % CI, 0.35-0.91) compared to osimertinib group. In subgroup analyses, the aspirin-associated PFS benefit was observed in patients with and without central nervous system (CNS) metastases, as well as in osimertinib first-line setting and in subsequent line setting. The median PFS in EGFR 19Del patients was longer than EGFR L858R patients with osimertinib, and when aspirin was added, the median PFS significantly improved in both groups regardless of lines of therapy. The benefit from aspirin was independent of age, gender, TP53 mutational status, or PD-L1 positivity. CONCLUSION: Concurrent aspirin use with osimertinib in EGFR-mutant NSCLC patients was associated with improved survival, regardless of lines of therapy, CNS metastatic status, EGFR mutation type, age, gender, TP53, and PD-L1 status.
BACKGROUND: Osimertinib is the treatment of choice for advanced EGFR-mutant non-small cell lung cancer (NSCLC). However, novel strategies to improve the duration of disease control are still urgently needed. Aspirin has been shown to decrease cancer incidence and improve outcomes in various malignancies. Therefore, we evaluated a cohort of patients who received osimertinib with or without concurrent use of aspirin to assess whether the addition of aspirin may lead to improved clinical outcomes. METHODS: MD Anderson Cancer Center GEMINI database was retrospectively queried for EGFR-mutant NSCLC patients who received osimertinib with or without concurrent use of aspirin for progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 365 patients were identified including 77 which had concurrent use of aspirin. Patients in the aspirin-osimertinib group had significantly improved PFS (21.3 vs 11.6 months; HR, 0.52; 95 % CI, 0.38-0.70) and OS (Not reached vs 32.3 months; HR, 0.56; 95 % CI, 0.35-0.91) compared to osimertinib group. In subgroup analyses, the aspirin-associated PFS benefit was observed in patients with and without central nervous system (CNS) metastases, as well as in osimertinib first-line setting and in subsequent line setting. The median PFS in EGFR 19Del patients was longer than EGFR L858R patients with osimertinib, and when aspirin was added, the median PFS significantly improved in both groups regardless of lines of therapy. The benefit from aspirin was independent of age, gender, TP53 mutational status, or PD-L1 positivity. CONCLUSION: Concurrent aspirin use with osimertinib in EGFR-mutant NSCLC patients was associated with improved survival, regardless of lines of therapy, CNS metastatic status, EGFR mutation type, age, gender, TP53, and PD-L1 status.
Authors: Kostyantyn Krysan; Jay M Lee; Mariam Dohadwala; Brian K Gardner; Karen L Reckamp; Edward Garon; Maie St John; Sherven Sharma; Steven M Dubinett Journal: J Thorac Oncol Date: 2008-02 Impact factor: 15.609
Authors: Tracey G Simon; Ann-Sofi Duberg; Soo Aleman; Raymond T Chung; Andrew T Chan; Jonas F Ludvigsson Journal: N Engl J Med Date: 2020-03-12 Impact factor: 91.245
Authors: Jacqulyne P Robichaux; Xiuning Le; R S K Vijayan; J Kevin Hicks; Simon Heeke; Yasir Y Elamin; Heather Y Lin; Hibiki Udagawa; Ferdinandos Skoulidis; Hai Tran; Susan Varghese; Junqin He; Fahao Zhang; Monique B Nilsson; Lemei Hu; Alissa Poteete; Waree Rinsurongkawong; Xiaoshan Zhang; Chenghui Ren; Xiaoke Liu; Lingzhi Hong; Jianjun Zhang; Lixia Diao; Russell Madison; Alexa B Schrock; Jennifer Saam; Victoria Raymond; Bingliang Fang; Jing Wang; Min Jin Ha; Jason B Cross; Jhanelle E Gray; John V Heymach Journal: Nature Date: 2021-09-15 Impact factor: 69.504
Authors: Lingzhi Hong; Whitney E Lewis; Monique Nilsson; Sonia Patel; Susan Varghese; Melvin J Rivera; Robyn R Du; Pingjun Chen; Haley N Kemp; Waree Rinsurongkawong; Simon Heeke; Amy R Spelman; Yasir Y Elamin; Marcelo V Negrao; Boris Sepesi; Don L Gibbons; J Jack Lee; Jia Wu; Natalie I Vokes; John V Heymach; Jianjun Zhang; Xiuning Le Journal: Cancers (Basel) Date: 2022-07-17 Impact factor: 6.575