Clinical Outcomes With Dabrafenib Plus Trametinib in a Clinical Trial Versus Real-World Standard of Care in Patients With BRAF-Mutated Advanced NSCLC

Johnson, Bruce E.; Baik, Christina S.; Groen, Harry J.M.; Melosky, Barbara; Wolf, Jürgen; Kolaei, Fatemeh Asad Zadeh Vosta; Wu, Weiguo; Knoll, S.; Dawson, Meryem Ktiouet; Johns, Adam M.; Planchard, David

doi:10.1016/j.jtocrr.2022.100324

Cited by 5 publications

(3 citation statements)

References 31 publications

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“…Our results underscore the fundamental role of molecular targeted therapies in improving the 5-year OS in patients with NSCLC, corroborating the findings of Lee, D.H. in the PIvOTAL observational study, which also highlights the significance of molecular testing for optimizing treatment strategies [17]. Molecular targeting agents, specifically those targeting EGFR [6,18], ALK [19][20][21], ROS1 [22], and BRAF [23], have shown superior outcomes in clinical trials involving patients with favorable conditions, surpassing the results achieved by standard therapies. Our findings corroborate other similar reports [24][25][26][27], emphasizing the necessity of comprehensive genetic testing to identify appropriate candidates for molecular targeted therapies in a more general patient population.…”

Section: Discussionsupporting

confidence: 86%

Tailoring Therapeutic Strategies in Non-Small-Cell Lung Cancer: The Role of Genetic Mutations and Programmed Death Ligand-1 Expression in Survival Outcomes

Kobayashi,

Miura,

Kaneko

et al. 2023

Cancers

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Background: This study aims to assess the real-world impact of advancements in first-line systemic therapies for non-small-cell lung cancer (NSCLC), focusing on the role of driver gene mutations and programmed death-ligand 1 (PD-L1) expression levels. Methods: Conducted across eight medical facilities in Japan, this multicenter, retrospective observational research included 863 patients diagnosed with NSCLC and treated between January 2015 and December 2022. The patients were categorized based on the type of systemic therapy received: cytotoxic agents, molecular targeting agents, immune checkpoint inhibitors, and combination therapies. Comprehensive molecular and immunohistochemical analyses were conducted, and statistical evaluations were performed. Results: The median overall survival (OS) shows significant variations among treatment groups, with targeted therapies demonstrating the longest OS. This study also revealed that high PD-L1 expression was common in the group treated with immune checkpoint inhibitors. Multivariate analysis was used to identify the type of anticancer drug and the expression of PD-L1 at diagnosis as the impactful variables affecting 5-year OS. Conclusions: This study underscores the efficacy of targeted therapies and the critical role of comprehensive molecular diagnostics and PD-L1 expression in affecting OS in NSCLC patients, advocating for their integration into routine clinical practice.

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Section: Discussionsupporting

confidence: 86%

Tailoring Therapeutic Strategies in Non-Small-Cell Lung Cancer: The Role of Genetic Mutations and Programmed Death Ligand-1 Expression in Survival Outcomes

Kobayashi,

Miura,

Kaneko

et al. 2023

Cancers

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“…The comparison between dabrafenib-trametinib and single-agent immunotherapy (mainly pembrolizumab or nivolumab) was then performed only for patients treated in second line, with dabrafenib-trametinib not showing statistically significant survival benefit over ICIs. 41 …”

Section: Reviewmentioning

confidence: 99%

Non-small-cell lung cancer: how to manage BRAF-mutated disease

Guaitoli¹,

Zullo²,

Tiseo³

et al. 2023

DIC

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BRAF mutations are reported in about 3–5% of non-small-cell lung cancer (NSCLC), almost exclusively in adenocarcinoma histology, and are classified into three different classes. The segmentation of BRAF mutations into V600 (class 1) and non-V600 (classes 2 and 3) relies on their biological characteristics and is of interest for predicting the therapeutic benefit of targeted therapies and immunotherapy. Given the relative rarity of this molecular subset of disease, evidence supporting treatment choices is limited. This review aims to offer a comprehensive update about available therapeutic options for patients with NSCLC harbouring BRAF mutations to guide the physician in the choice of treatment strategies. We collected the most relevant available data, from single-arm phase II studies and retrospective analyses conducted in advanced NSCLC, regarding the efficacy of BRAF and MEK inhibitors in both V600 and non-V600 BRAF mutations. We included case reports and smaller experiences that could provide information on specific alterations. With respect to immunotherapy, we reviewed retrospective evidence on immune-checkpoint inhibitors in this molecular subset, whereas data about chemo-immunotherapy in this molecular subgroup are lacking. Moreover, we included the available, though limited, retrospective evidence of immunotherapy as consolidation after chemo-radiation for unresectable stage III BRAF -mutant NSCLC, and an overview of ongoing clinical trials in the peri-operative setting that could open new perspectives in the future.

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“…The Raw dataset was examined as independent features and tested for relevancy of data in comparison with the remaining features. The test was completed for finding missing values [24] , non-numeric or text values [25] , empty values, Not-A-Number (NAN) [26] and NULL [27] values. The missing and empty values represent the nonavailability of values in the feature set.…”

Section: Test For Relevance and Numeracy Valuesmentioning

confidence: 99%

Identification of Irrelevant Features in Clinical Non-Small Cell Lung Cancer Data Using Reverse Feature Elimination Model

Mani¹,

Parthiban²

2022

INDJCSE

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Non-Small Cell Lung Cancer (NSCLC) developed as a malignant cell cancer in the major regions of lungs thus identified as one of the life-threatening diseases. Many factors constitute to the development of this type of cancer in human lungs in both active or passive form. The major objective of this research paper is to identify the irrelevant factors or symptoms from a high dimensional clinical NSCLC dataset with 31 features using a novel Reverse Feature Elimination Dimensionality Reduction (RFEDR) algorithm designed for identifying worst features through Best Cost ranking technique applied in the dataset. In the initial stage pre-processing, 3 features (Admission-ID, Age and Gender) were removed in three filter stages and Feature Elimination method is applied. At the end of the implementation process with 40 iterations, the line of convergence was obtained Iteration 7 to 27. The best cost was determined to be 1.0042e-26 and the worst features through reverse elimination algorithm was identified as rare Alcohol Intake (Feature 2), Work Threats (Feature-4), Smoking Habit (Feature-9), Cold (Feature-20), Snoring (Feature-22) and Headache (Feature-27) respectively. The research sublimated the importance of eliminating irrelevant features apart from selecting best features for better prediction.

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Clinical Outcomes With Dabrafenib Plus Trametinib in a Clinical Trial Versus Real-World Standard of Care in Patients With BRAF-Mutated Advanced NSCLC

Cited by 5 publications

References 31 publications

Tailoring Therapeutic Strategies in Non-Small-Cell Lung Cancer: The Role of Genetic Mutations and Programmed Death Ligand-1 Expression in Survival Outcomes

Tailoring Therapeutic Strategies in Non-Small-Cell Lung Cancer: The Role of Genetic Mutations and Programmed Death Ligand-1 Expression in Survival Outcomes

Non-small-cell lung cancer: how to manage BRAF-mutated disease

Identification of Irrelevant Features in Clinical Non-Small Cell Lung Cancer Data Using Reverse Feature Elimination Model

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