Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations in China

Xu, Jianlin; Zhang, Yanwei; Jin, Bo; Chu, Tianqing; Dong, Xue; Yang, Haitang; Wu, Dan; Lou, Yu‐Qing; Zhang, Xueyan; Wang, Huiming; Han, Baohui

doi:10.1007/s00432-016-2133-4

Cited by 20 publications

(24 citation statements)

References 31 publications

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“…Patients with adenocarcinoma had a higher mutation rate than those with non-adenocarcinoma (50.2% vs 17.0%, P <0.001). A retrospective analysis in 2016 tested 597 non-adenocarcinoma NSCLC patients,9 and the EGFR mutation rate was 12.9%. Cho et al reported 1,255 patients with advanced NSCLC who accepted gefitinib at Samsung Medical Center between January 2007 and July 2010 10.…”

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Non-adenocarcinomasmentioning

confidence: 99%

“…The efficacy of TKIs in EGFR-mutated squamous carcinoma was not very good, the response rate was 26.7%–38.0%, and the mPFS was 3.1–3.98 months (Table 3). Xu et al tested EGFR mutation in 597 non-adenocarcinoma NSCLC patients,9 and the squamous carcinomas among them were 457. The number of patients harboring EGFR mutation was 47, and 26 patients among them accepted TKIs (including gefitinib, erlotinib, and icotinib); the response rate was 30.8% and the mPFS was 3.98 months.…”

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Squamous Carcinomasmentioning

confidence: 99%

“…Wen et al tested postoperative fresh specimens of 694 NSCLC patients using ARMS method;13 68 among them were adenosquamous carcinoma, and 17 adenosquamous carcinoma patients had EGFR mutation and the mutation rate was 25%. Xu et al tested the EGFR status of 597 non-adenocarcinoma patients;9 43 among them were adenosquamous carcinoma, and 18 patients had EGFR mutation and the mutation rate was 41.86% (Table 4). Shukuya et al made a pooling analysis of the published literature in 2005–2009,16 including five prospective and 10 retrospective studies.…”

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Adenosquamous Camentioning

confidence: 99%

“…Cho et al treated three patients with EGFR-mutated adenosquamous carcinoma using gefitinib or erlotinib as second-line therapy,10 all of them accepted partial response, and the mPFS was 4.53, 8.23, and 13.53 months, respectively. Xu et al published a retrospective analysis in 2016;9 totally, 15 patients with EGFR-mutated adenosquamous carcinoma were reported, nine patients among them accepted partial response, and the response rate was 60% (9/15) and the mPFS was 8.08 months (Table 5). …”

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Adenosquamous Camentioning

confidence: 99%

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Clinical efficacy evaluation of tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations

Song

Wang

2017

OTT

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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) as a standard therapy have been used in EGFR-mutated adenocarcinoma of non-small-cell lung cancer (NSCLC) patients in recent years. But in current randomized prospective clinical trials, due to few cases of non-adenocarcinoma patients having been found, the efficacy of TKIs for EGFR-mutated non-adenocarcinoma and the relationship with clinicopathological characteristics remained debatable. The results of retrospective studies showed that the frequency of EGFR mutation was significantly associated with nationality, gender, smoking history, and histology type. Being female, never-smoker and adenocarcinoma had a higher mutation rate. Furthermore, the EGFR mutation rate and efficacies of TKIs in adenocarcinoma were higher than those in non-adenocarcinoma. And in non-adenocarcinoma, the EGFR mutation rate and efficacies of TKIs in adenosquamous cell carcinoma were higher than those in squamous cell carcinoma or in large-cell lung carcinoma. In conclusion, it may be necessary to conduct a large sample prospective study to understand the clinicopathological characteristics of non-adenocarcinomas and to evaluate the efficacy of EGFR TKI and/or chemotherapy for EGFR-mutated non-adenocarcinoma NSCLC. So we searched relevant articles between the year 2010 and 2016 through the major indexed literature database PubMed by searching the keywords such as EGFR mutation, Tyrosine kinase inhibitors, and Non-adenocarcinoma.

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Section: Efficacy Evaluation Of Tkis In Egfr-mutated Non-adenocarcinomasmentioning

confidence: 99%

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Squamous Carcinomasmentioning

confidence: 99%

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Adenosquamous Camentioning

confidence: 99%

Section: Efficacy Evaluation Of Tkis In Egfr-mutated Adenosquamous Camentioning

confidence: 99%

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Clinical efficacy evaluation of tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations

Song

Wang

2017

OTT

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“…In the past decade, the superior response of pulmonary adenocarcinoma with EGFR mutations to TKIs has changed the treatment guidelines, especially for elderly patients and those with locally advanced or metastatic pulmonary adenocarcinoma [6]. More recent research has also confirmed the presence of EGFR mutations in other types of lung cancer [7] and in triple negative breast cancer [4]. However, the EGFR mutation rate is extremely low in non-adenocarcinoma NSCLC.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis Discrepancy from Different Original Specimen in PCR EGFR Mutation Test

Tseng¹,

Wu²,

Wu³

et al. 2016

J Clin Case Rep

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Epidermal growth factor receptor (EGFR) mutation status guides treatment in non-small cell lung cancer; del E746-A750 in exon 19 and p.L858R in exon 21 are the most common mutations. We present a patient whose initial lymph node and computed tomography-guided pathology led to a suspicion of poorly differentiated carcinoma; however, during the clinical course, no obvious tumor origin was noted, and the pathologic morphology favored the squamous type. Not until the EGFR mutation status of secondary sites was checked did we confirm the disease origin as the lung.

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Evaluation of Clinical Outcomes of Icotinib in Patients With Clinically Diagnosed Advanced Lung Cancer With EGFR-Sensitizing Variants Assessed by Circulating Tumor DNA Testing

Liu²,

Bai

et al. 2022

JAMA Oncol

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The inability to obtain a pathological diagnosis in a certain proportion of patients with clinically diagnosed advanced lung cancer impedes precision treatment in clinical practice. OBJECTIVE To evaluate the clinical outcome of first-line icotinib in patients with clinically diagnosed advanced lung cancer with unknown pathological status and positive epidermal growth factor receptor (EGFR)-sensitizing variants assessed by circulating tumor DNA (ctDNA). DESIGN, SETTING, AND PARTICIPANTS The Efficiency of Icotinib in Plasma ctDNA EGFR Mutation-Positive Patients Diagnosed With Lung Cancer (CHALLENGE) trial is a prospective, multicentered, open-label, single-arm phase 2 nonrandomized clinical trial conducted between July 1, 2017, and July 31, 2019. Patients with systemic treatment-naive, clinically diagnosed advanced peripheral lung cancer, unknown pathological status, and positive pretreatment plasma EGFR-sensitizing variants were eligible. A total of 391 potentially eligible Chinese patients from 19 centers in China were screened for ctDNA EGFR variants by 3 independent detection platforms (Super amplification refractory mutation system [SuperARMS] polymerase chain reaction, droplet digital polymerase chain reaction, and next-generation sequencing), and those with EGFR variants tested by any platform were included. Analyses were conducted from September 9 to December 31, 2021.INTERVENTIONS Enrolled patients were treated with oral icotinib tablets (125 mg 3 times daily) until disease progression, death, or treatment discontinuation due to various reasons, such as toxic effects and withdrawing consent. MAIN OUTCOMES AND MEASURESThe primary end point was objective response rate (ORR). The secondary end points included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and the concordance among the 3 detection platforms. RESULTSOf 116 included patients, 76 (65.5%) were female, and the median (range) age was 64 (37-85) years. The median (IQR) follow-up duration was 36.3 (30.2-40.7) months. The ORR was 52.6% (95% CI, 43.1%-61.9%). The median PFS and OS were 10.3 months (95% CI, 8.3-12.2) and 23.2 months (95% CI, 17.7-28.0), respectively, and the DCR was 84.5% (95% CI, 76.6%-90.5%). The concordance rate among the 3 detection platforms was 80.1% (313 of 391), and the clinical outcomes in patients identified as positive by any platform were comparable.CONCLUSIONS AND RELEVANCE This prospective phase 2 nonrandomized clinical trial suggests that for patients with clinically diagnosed advanced lung cancer with unknown pathological status, ctDNA-based EGFR genotyping could help decision-making in particular clinical situations, while still warranting future larger-scaled real-world exploration.

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Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations in China

Abstract: EGFR TKIs could be an option for the treatment of EGFR-mutated non-adenocarcinoma NSCLC, especially for patients with adenosquamous histology and non-smokers.

Cited by 20 publications

References 31 publications

Clinical efficacy evaluation of tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations

Clinical efficacy evaluation of tyrosine kinase inhibitors for non-adenocarcinoma lung cancer patients harboring EGFR-sensitizing mutations

Diagnosis Discrepancy from Different Original Specimen in PCR EGFR Mutation Test

Evaluation of Clinical Outcomes of Icotinib in Patients With Clinically Diagnosed Advanced Lung Cancer With EGFR-Sensitizing Variants Assessed by Circulating Tumor DNA Testing

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