BACKGROUND: EGFR tyrosine kinase inhibitor (TKI) is recommended as the first-line therapy for patients with EGFR-mutant metastatic non-small cell lung cancer (NSCLC). Yet, resistance often occurs in 1 year after therapy and most progressions occur at the initial sites of disease. Addition of local therapy to the first-line TKI therapy may delay the progression and provide survival benefit to the patients. METHODS: From 2010 to 2017, metastatic NSCLC patients with EGFR activating mutations who received first-line TKI and relatively radical local therapy (RRLT) were reviewed. RRLT was defined as local curative therapy to the main site or any intensity of local therapy to all sites of disease. The Kaplan-Meier method and log-rank test were used for survival estimation and comparison. RESULTS: A total of 45 patients were included in this retrospective study with a median follow-up of 48.0 months. The median progression-free survival (PFS) and overall survival (OS) was 17.0 months (95% confidence interval [CI]: 14.6-19.3) and 55.0 months (95% CI: 49.3-60.6), respectively. Univariate analysis indicated that age ⩽ 60 years (P = .019), first-line TKI duration ⩾ 10 months (P = .028), and accumulated TKI duration ⩾ 20 months (P = .016) were significantly associated with favorable OS. Among the 36 patients who progressed during the follow-up, 55.8% of the progressions occurred at the new sites. RRLT combined with TKI did not show any severe toxicity to the patients. CONCLUSIONS: Combined application of RRLT and first-line TKI may improve the survival and alter the pattern of failure for metastatic NSCLC patients with EGFR activating mutations.
BACKGROUND: EGFR tyrosine kinase inhibitor (TKI) is recommended as the first-line therapy for patients with EGFR-mutant metastatic non-small cell lung cancer (NSCLC). Yet, resistance often occurs in 1 year after therapy and most progressions occur at the initial sites of disease. Addition of local therapy to the first-line TKI therapy may delay the progression and provide survival benefit to the patients. METHODS: From 2010 to 2017, metastatic NSCLC patients with EGFR activating mutations who received first-line TKI and relatively radical local therapy (RRLT) were reviewed. RRLT was defined as local curative therapy to the main site or any intensity of local therapy to all sites of disease. The Kaplan-Meier method and log-rank test were used for survival estimation and comparison. RESULTS: A total of 45 patients were included in this retrospective study with a median follow-up of 48.0 months. The median progression-free survival (PFS) and overall survival (OS) was 17.0 months (95% confidence interval [CI]: 14.6-19.3) and 55.0 months (95% CI: 49.3-60.6), respectively. Univariate analysis indicated that age ⩽ 60 years (P = .019), first-line TKI duration ⩾ 10 months (P = .028), and accumulated TKI duration ⩾ 20 months (P = .016) were significantly associated with favorable OS. Among the 36 patients who progressed during the follow-up, 55.8% of the progressions occurred at the new sites. RRLT combined with TKI did not show any severe toxicity to the patients. CONCLUSIONS: Combined application of RRLT and first-line TKI may improve the survival and alter the pattern of failure for metastatic NSCLC patients with EGFR activating mutations.
Authors: David A Palma; Robert Olson; Stephen Harrow; Stewart Gaede; Alexander V Louie; Cornelis Haasbeek; Liam Mulroy; Michael Lock; George B Rodrigues; Brian P Yaremko; Devin Schellenberg; Belal Ahmad; Gwendolyn Griffioen; Sashendra Senthi; Anand Swaminath; Neil Kopek; Mitchell Liu; Karen Moore; Suzanne Currie; Glenn S Bauman; Andrew Warner; Suresh Senan Journal: Lancet Date: 2019-04-11 Impact factor: 79.321
Authors: Andrew J Weickhardt; Benjamin Scheier; Joseph Malachy Burke; Gregory Gan; Xian Lu; Paul A Bunn; Dara L Aisner; Laurie E Gaspar; Brian D Kavanagh; Robert C Doebele; D Ross Camidge Journal: J Thorac Oncol Date: 2012-12 Impact factor: 15.609
Authors: Andrea Ardizzoni; Luca Boni; Marcello Tiseo; Frank V Fossella; Joan H Schiller; Marianne Paesmans; Davorin Radosavljevic; Adriano Paccagnella; Petr Zatloukal; Paola Mazzanti; Donald Bisset; Rafael Rosell Journal: J Natl Cancer Inst Date: 2007-06-06 Impact factor: 13.506
Authors: Phillip J Gray; Raymond H Mak; Beow Y Yeap; Sarah K Cryer; Nancy E Pinnell; Laura W Christianson; David J Sher; Nils D Arvold; Elizabeth H Baldini; Aileen B Chen; David E Kozono; Scott J Swanson; David M Jackman; Brian M Alexander Journal: Lung Cancer Date: 2014-06-06 Impact factor: 5.705
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