Gefitinib as first-line treatment for patients with advanced non-small-cell lung cancer with activating Epidermal Growth Factor Receptor mutation: Implications for clinical practice and open issues

Gridelli, Cesare; Marinis, Filippo de; Maïo, Massimo Di; Cortinovis, Diego; Cappuzzo, Federico; Mok, Tony

doi:10.1016/j.lungcan.2010.12.009

Cited by 40 publications

(28 citation statements)

References 33 publications

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“…In order to improve treatment, the choice of targeted treatment is increasingly based on predictive factors such as histological subtype or biomarkers, e.g. epidermal growth factor receptor mutations [7] or EML4-ALK gene rearrangements [8]. No…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of ki-67 labeling index in non-small cell lung cancer

2013

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Section: Introductionmentioning

confidence: 99%

Clinical impact of ki-67 labeling index in non-small cell lung cancer

2013

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“…2 Epidermal growth factor receptor (EGFR) mutations occur in the majority of female, nonsmoking Asian patients with lung adenocarcinoma. 3,4 The success of EGFR small-molecule tyrosine kinase inhibitors (EGFR-TKIs) in lung adenocarcinoma treatment 5 has allowed the use of EGFR mutation status to select patients who are suitable for firstline therapy with these drugs. 6 The most common EGFR mutations -exon 19 deletion (19-Del) and L858R -can be used to predict response to EGFR-TKI therapy; 7 in addition, EGFR mutations can be used as an indication for EGFR-TKI treatment.…”

Section: Introductionmentioning

confidence: 99%

Frequency of EGFR mutations in lung adenocarcinoma with malignant pleural effusion: Implication of cancer biological behaviour regulated by EGFR mutation

et al. 2014

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Objective: A retrospective single-centre study to compare the clinical features of patients with lung adenocarcinoma with and without epidermal growth factor receptor (EGFR) mutations. Methods: Pretreatment medical records of patients with lung adenocarcinoma were reviewed. DNA was extracted from paraffin wax-embedded tumour tissue for analysis of EGFR mutations. Malignant pleural effusion (MPE) was diagnosed by cytopathological testing of pleural fluid. Results: EGFR mutations (19-Del and L858R) were recorded in 81/283 patients (28.6%). MPE was found in 42/283 patients (14.8%). In patients with stage IV disease, the frequency of EGFR mutations was higher in those with MPE than in those without MPE. EGFR mutations were independently associated with female sex, no history of smoking and presence of MPE. Conclusions: There was a positive association between EGFR mutation and the presence of MPE. EGFR mutations may play an important role in the formation of MPE.

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“…However, the prediction of a response by mutation analysis only is suboptimal (7,8). It is known that some patients without apparent sensitizing EGFR mutations do benefit from erlotinib therapy (9), perhaps because of heterogeneity within tumors or the limitation of biopsy analysis not always showing relevant mutations. On the other hand, patients who do not respond to EGFR TKIs, despite the presence of activating mutations, could be spared unnecessary toxicity and costs.…”

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confidence: 99%

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

et al. 2014

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The purpose of this study was to prospectively evaluate the timing of metabolic response monitoring with 18 F-FDG PET of (neoadjuvant) erlotinib treatment in patients with early-stage non-small cell lung cancer. Methods: This study was designed as an open-label phase II trial performed in 4 hospitals in The Netherlands. Patients received preoperative erlotinib (150 mg) once daily for 3 wk. Response evaluation was performed after 4-7 d and at 3 wk with 18 F-FDG PET/CT scans. Tumor 18 F-FDG uptake and changes were measured as standardized uptake values (SUVs). The metabolic response was classified on the basis of European Organization for Research and Treatment of Cancer criteria (.25% decrease in the maximum SUV) and was compared with histopathologic regression as observed in the resection specimen. Results: From December 2006 to November 2010, 60 patients with non-small cell lung cancer eligible for surgical resection were enrolled in this study. For 43 patients (18 men and 25 women), baseline 18 F-FDG PET/CT scans as well as both monitoring scans and histopathologic response monitoring were available. A partial metabolic response on 18 F-FDG PET/CT scans was observed for 10 patients (23%) after 1 wk and for 14 patients (33%) after 3 wk. Histopathologic examination revealed regression (necrosis of .50%) in 11 patients (26%). In these patients, the maximum SUV decreased by a mean of 17% within 1 wk and a mean of 31% at 3 wk. Seven patients were identified as responders within 1 wk. Conclusion: Response monitoring with 18 F-FDG PET/CT within 1 wk after the start of erlotinib treatment identified approximately 64% of histopathologic responders on the basis of European Organization for Research and Treatment of Cancer criteria.

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Gefitinib as first-line treatment for patients with advanced non-small-cell lung cancer with activating Epidermal Growth Factor Receptor mutation: Implications for clinical practice and open issues

Cited by 40 publications

References 33 publications

Clinical impact of ki-67 labeling index in non-small cell lung cancer

Clinical impact of ki-67 labeling index in non-small cell lung cancer

Frequency of EGFR mutations in lung adenocarcinoma with malignant pleural effusion: Implication of cancer biological behaviour regulated by EGFR mutation

Timing of Metabolic Response Monitoring During Erlotinib Treatment in Non–Small Cell Lung Cancer

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