Comprehensive Analysis of the Incidence and Survival Patterns of Lung Cancer by Histologies, Including Rare Subtypes, in the Era of Molecular Medicine and Targeted Therapy

Chang, Jeffrey S.; Chen, Li Tzong; Shan, Yan Shen; Lin, Shiu-Shiung; Hsiao, Sheng Yen; Tsai, Cheng-Chung; Yu, Shunli; Tsai, Hung-Pei

doi:10.1097/md.0000000000000969

Cited by 41 publications

(39 citation statements)

References 36 publications

(44 reference statements)

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“…Treatment-associated adverse events of TKI and chemotherapy groups. reported to be higher compared with that in patients with lung squamous cell carcinoma owing to the introduction of EGFR TKI therapy (18). However, the reasons for the survival difference between patients with lung adenocarcinoma not harboring EGFR mutations and patients with squamous cell carcinoma in the present study remain unclear.…”

Section: Discussioncontrasting

confidence: 48%

Efficacy of second‑line treatment and importance of comorbidity scores and clinical parameters affecting prognosis in elderly patients with non‑small cell lung cancer without epidermal growth factor receptor mutations

et al. 2017

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Abstract. The present study investigated the importance of comorbidity scores and clinical parameters in elderly patients with non-small cell lung cancer (NSCLC) not harboring epidermal growth factor receptor (EGFR) mutations who received second-line chemotherapy. The present study also compared the efficacy of tyrosine kinase inhibitor and cytotoxic chemotherapy as second-line treatment in elderly patients. The present study retrospectively reviewed the treatment of elderly patients with NSCLC (≥70 years old) who received second-line chemotherapy at Korea University Guro Hospital. Patients who had an EGFR mutation were excluded from the analysis. Between 2005 and 2013, 126 patients were included in the present study. The median progression-free survival (PFS) and overall survival (OS) for all patients who received second-line treatment were 2.47 months [95% confidence interval (CI), 2.08-2.86] and 8.63 months (95% CI, 5.99-11.28), respectively. A total of 52 patients (41.3%) were treated with tyrosine kinase inhibitor (TKI) and 74 (58.7%) were treated with chemotherapy. No difference was observed in the median PFS and OS between the TKI and chemotherapy groups (P=0.287 for PFS and P=0.374 for OS). The Charlson comorbidity index was not associated with survival, whereas a simplified comorbidity score and clinical factors, including poor performance status, short PFS of first-line chemotherapy, presence of brain metastasis and low serum albumin and sodium levels were significant prognostic factors in these elderly patients. Second-line chemotherapy was not beneficial to patients who had at least 3 of these factors and a median OS of 1.73 months, whereas patients who had less than 2 of these factors had a median OS of 11.50 months. For elderly lung cancer patients without EGFR mutations, clinical parameters were the most important factors affecting survival, rather than the types of drugs.

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Section: Discussioncontrasting

confidence: 48%

Efficacy of second‑line treatment and importance of comorbidity scores and clinical parameters affecting prognosis in elderly patients with non‑small cell lung cancer without epidermal growth factor receptor mutations

et al. 2017

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“…Population-based cancer registries are essential for assessing the current cancer burden of the healthcare systems, as well as to monitor the efficacy of cancer prevention and treatment strategies. Regarding lung cancer epidemiology in Taiwan, limited data were available in global cancer surveillance and information reported in previous studies has become outdated [13,14]. In this population-based epidemiologic study, we managed to update the trends of the prevalence, incidence, and overall survival of patients with lung cancer in Taiwan between 2002 and 2014 by combining information from the National Health Insurance Research Database (NHIRD), Taiwan Cancer Registry Database (TCRD), and National Death Registry (NDR).…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

Lin

Liu

et al. 2019

BioMed Research International

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Purpose. Lung cancer has been the top-ranking cause of cancer deaths in Taiwan for decades. Limited data were available in global cancer surveillance regarding lung cancer epidemiology in Taiwan, and previous reports are outdated. Patients and Methods. This population-based cohort study extracted data of patients with lung cancer from the Taiwan National Health Insurance database and determined the lung cancer incidence and prevalence during 2002–2014. Histological subtypes were retrieved from the Taiwan Cancer Registry database; survival rates were gathered from the National Death Registry. Average annual percentage changes (APCs) of prevalence, incidence, and overall survival were estimated by joinpoint regression analysis. Results. Age-standardized incidence of lung cancer increased from 45.04 per 100,000 person-years in 2002 to 49.86 per 100,000 person-years in 2014, with an average APC of 0.7 (95% CI = 0.3–1.1; 0.2 in males, 2.0 in females). Lung cancer was more prevalent in male patients, but this increase gradually slowed down. Socioeconomic analysis showed that lung cancer has higher prevalence in patients with higher income level and urban residency. Adenocarcinoma was the most abundant histological subtype in Taiwan (adenocarcinoma-to-squamous cell carcinoma ratio = 4.16 in 2014), with a 2.4-fold increase of incident cases during 2002–2014 (from 43.47% to 64.89% of all lung cancer cases). The 5-year survival rate of lung cancer patients in 2010 was 17.34% (12.60% in male, 25.40% in female), with an average APC of 9.3 (6.3 in male, 11.8 in female) during 2002–2010. Conclusion. Average APCs of prevalence and incidence of lung cancer were 3.1 and 0.7, respectively, during 2002–2014 in Taiwan. The number of female patients and number of patients with adenocarcinoma have increased the most, with incident cases doubling in these years. Facing this fatal malignancy, it is imperative to improve risk stratification, encourage early surveillance, and develop effective therapeutics for lung cancer patients in Taiwan.

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“…Lung cancer is the most common malignant tumor worldwide, with increasing annual incidence and mortality trends (1). Non-small-cell lung cancer (NSCLC) accounts for 80-85% of all lung cancers (2).…”

Section: Introductionmentioning

confidence: 99%

Association between EGFR exon 19 or exon 21 mutations and survival rates after first‑line EGFR‑TKI treatment in patients with non‑small cell lung cancer

Jiang

Zhu

et al. 2019

mol clin onc

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Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is the first-line treatment for patients with advanced non-small-cell lung cancer (NSCLC) who have an EGFR mutation. However, little has been reported about the association between EGFR exon 19 deletions or an exon 21 mutation (specifically the L858R point mutation) and survival rates following first-line EGFR-TKI treatment in patients with NSCLC. As a retrospective study, 72 patients with stage IIIB/IV NSCLC carrying EGFR mutations (exon 19 deletions or an exon 21 mutation) were enrolled between 1 January 2008 and 31 December 2013, and all of the patients received first-line EGFR-TKI treatment. The associations between EGFR mutation status or clinical characteristics and response rate (ORR), progression-free survival (PFS) or overall survival (OS) were analyzed. Patients with exon 19 deletions (37 cases) had a higher ORR (75.7 vs. 51.4%; P=0.032), disease control rate (DCR; 89.2 vs. 68.6%; P= 0.031), modified median PFS (13.2 vs. 10.8 months; P=0.030) and OS (30.2 vs. 25.6 months; P=0.030) compared with those with an exon 21 mutation (35 cases). Cox multivariate analysis indicated that sex, histological type and smoking history were key factors that affected PFS and OS. Mutations status was associated with PFS, but not OS. Following EGFR-TKI therapy, a better ORR, DCR, PFS and OS was observed in patients with EGFR deletions in exon 19 compared with those with an exon 21 mutation. The EGFR mutation status of patients with non-small cell lung cancer may therefore predict the efficacy and prognosis of EGFR-TKI.

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Comprehensive Analysis of the Incidence and Survival Patterns of Lung Cancer by Histologies, Including Rare Subtypes, in the Era of Molecular Medicine and Targeted Therapy

Abstract: Supplemental Digital Content is available in the text

Cited by 41 publications

References 36 publications

Efficacy of second‑line treatment and importance of comorbidity scores and clinical parameters affecting prognosis in elderly patients with non‑small cell lung cancer without epidermal growth factor receptor mutations

Efficacy of second‑line treatment and importance of comorbidity scores and clinical parameters affecting prognosis in elderly patients with non‑small cell lung cancer without epidermal growth factor receptor mutations

Epidemiology and Survival Outcomes of Lung Cancer: A Population-Based Study

Association between EGFR exon 19 or exon 21 mutations and survival rates after first‑line EGFR‑TKI treatment in patients with non‑small cell lung cancer

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