PURPOSE: This study aimed to explore the clinical value of SBRT for primary lung lesions of EGFR-mutant NSCLC patients with non-oligometastatic disease during first-line EGFR-TKI treatment. METHODS: We identified patients with stage IV EGFR-mutant non-oligometastatic NSCLC who were suitable to receive SBRT for the primary tumors after EGFR-TKI treatment. All selected patients were treated with first-line EGFR-TKIs and SBRT for their primary lesions. The primary endpoints were the progression-free survival 1 (PFS1, time of first TKI dose relative to disease progression based on RECIST) and PFS2 (time of first TKI dose relative to disease progression after SBRT). The secondary endpoints were overall survival (OS) and safety. RESULTS: Seventy-nine patients were enrolled, including 45 patients who received SBRT for their primary tumor at the maximal response of EGFR-TKI (the preemptive RT group) and 34 patients who received SBRT for their primary tumor after the occurrence of oligoprogression (the delayed RT group). The preemptive RT group had a significantly better median PFS1 than the delayed RT group (22.3 months vs. 12.9 months, P = 0.0031). The median PFS2 in the preemptive RT and delayed RT groups were 22.3 and 28.9 months, respectively (P = 0.17). The median OS did not differ significantly between the preemptive RT group and the delayed RT group (46.6 versus 51.3 months, P = 0.54). No severe toxicities (≥ grade 3) were recorded. CONCLUSION: This real-world study showed that preemptive RT to primary lung tumors is a feasible option for selected patients with EGFR-mutant non-oligometastatic NSCLC who had stable disease during first-line EGFR-TKI treatment, and that it significantly improved PFS.
PURPOSE: This study aimed to explore the clinical value of SBRT for primary lung lesions of EGFR-mutant NSCLC patients with non-oligometastatic disease during first-line EGFR-TKI treatment. METHODS: We identified patients with stage IV EGFR-mutant non-oligometastatic NSCLC who were suitable to receive SBRT for the primary tumors after EGFR-TKI treatment. All selected patients were treated with first-line EGFR-TKIs and SBRT for their primary lesions. The primary endpoints were the progression-free survival 1 (PFS1, time of first TKI dose relative to disease progression based on RECIST) and PFS2 (time of first TKI dose relative to disease progression after SBRT). The secondary endpoints were overall survival (OS) and safety. RESULTS: Seventy-nine patients were enrolled, including 45 patients who received SBRT for their primary tumor at the maximal response of EGFR-TKI (the preemptive RT group) and 34 patients who received SBRT for their primary tumor after the occurrence of oligoprogression (the delayed RT group). The preemptive RT group had a significantly better median PFS1 than the delayed RT group (22.3 months vs. 12.9 months, P = 0.0031). The median PFS2 in the preemptive RT and delayed RT groups were 22.3 and 28.9 months, respectively (P = 0.17). The median OS did not differ significantly between the preemptive RT group and the delayed RT group (46.6 versus 51.3 months, P = 0.54). No severe toxicities (≥ grade 3) were recorded. CONCLUSION: This real-world study showed that preemptive RT to primary lung tumors is a feasible option for selected patients with EGFR-mutant non-oligometastatic NSCLC who had stable disease during first-line EGFR-TKI treatment, and that it significantly improved PFS.
Authors: Rafael Rosell; Enric Carcereny; Radj Gervais; Alain Vergnenegre; Bartomeu Massuti; Enriqueta Felip; Ramon Palmero; Ramon Garcia-Gomez; Cinta Pallares; Jose Miguel Sanchez; Rut Porta; Manuel Cobo; Pilar Garrido; Flavia Longo; Teresa Moran; Amelia Insa; Filippo De Marinis; Romain Corre; Isabel Bover; Alfonso Illiano; Eric Dansin; Javier de Castro; Michele Milella; Noemi Reguart; Giuseppe Altavilla; Ulpiano Jimenez; Mariano Provencio; Miguel Angel Moreno; Josefa Terrasa; Jose Muñoz-Langa; Javier Valdivia; Dolores Isla; Manuel Domine; Olivier Molinier; Julien Mazieres; Nathalie Baize; Rosario Garcia-Campelo; Gilles Robinet; Delvys Rodriguez-Abreu; Guillermo Lopez-Vivanco; Vittorio Gebbia; Lioba Ferrera-Delgado; Pierre Bombaron; Reyes Bernabe; Alessandra Bearz; Angel Artal; Enrico Cortesi; Christian Rolfo; Maria Sanchez-Ronco; Ana Drozdowskyj; Cristina Queralt; Itziar de Aguirre; Jose Luis Ramirez; Jose Javier Sanchez; Miguel Angel Molina; Miquel Taron; Luis Paz-Ares Journal: Lancet Oncol Date: 2012-01-26 Impact factor: 41.316
Authors: Daniel R Gomez; George R Blumenschein; J Jack Lee; Mike Hernandez; Rong Ye; D Ross Camidge; Robert C Doebele; Ferdinandos Skoulidis; Laurie E Gaspar; Don L Gibbons; Jose A Karam; Brian D Kavanagh; Chad Tang; Ritsuko Komaki; Alexander V Louie; David A Palma; Anne S Tsao; Boris Sepesi; William N William; Jianjun Zhang; Qiuling Shi; Xin Shelley Wang; Stephen G Swisher; John V Heymach Journal: Lancet Oncol Date: 2016-10-24 Impact factor: 41.316
Authors: Puneeth Iyengar; Zabi Wardak; David E Gerber; Vasu Tumati; Chul Ahn; Randall S Hughes; Jonathan E Dowell; Naga Cheedella; Lucien Nedzi; Kenneth D Westover; Suprabha Pulipparacharuvil; Hak Choy; Robert D Timmerman Journal: JAMA Oncol Date: 2018-01-11 Impact factor: 31.777