Key prognostic factors for EGFR-mutated non-adenocarcinoma lung cancer patients in the Japanese Joint Committee of Lung Cancer Registry Database

Kobayashi, Keigo; Soejima, Kenzo; Fukunaga, Koichi; Shintani, Yasushi; Sekine, Ikuo; Shukuya, Takehito; Takayama, K.; Inoue, Akira; Okamoto, Isamu; Kiura, Katsuyuki; Takahashi, Kazuhisa; Yamamoto, Nobuyuki; Takiguchi, Yuichi; Miyaoka, Etsuo; Okumura, Meinoshin; Yoshino, Ichiro

doi:10.1016/j.lungcan.2020.06.015

Cited by 8 publications

(4 citation statements)

References 44 publications

(46 reference statements)

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“…It was difficult to compare the details because of the small number of cases. Only two EGFR‐positive cases were confirmed among the nonadenocarcinoma cohort, supporting the established knowledge that EGFR mutations are rarely found in nonadenocarcinoma histology 25,26 …”

Section: Discussionsupporting

confidence: 65%

Clinical influence of switching companion diagnostic tests for EGFR‐TKs from Therascreen to Cobas v2

et al. 2021

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Background Several companion diagnostic (CDx) tests for epidermal growth factor receptor tyrosine kinase inhibitors (EGFR‐TKIs) have been approved. In our institute, the CDx test for EGFR‐TKIs was changed from the Therascreen test (Therascreen) to the Cobas EGFR v2 test (Cobas) because only Cobas was approved for the use of osimertinib in patients with EGFR‐mutated non‐small cell lung cancer (NSCLC) with T790M mutations. The clinical influence of switching the CDx test has not yet been examined comprehensively. Methods All serial patients with lung cancer tested for EGFR mutations with CDx tests between February 2014 and February 2016 at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research (JFCR) were enrolled in this analysis. Results Therascreen was used as a CDx test for EGFR‐TKI therapy in 607 patients between February 2014 and January 2015, and Cobas was used in 621 patients between February 2015 and February 2016. EGFR mutations were detected in 218 patients (35.9%) and 244 patients (39.3%) tested with Therascreen and Cobas, respectively. At the initial diagnosis, 400 and 459 patients were tested with Therascreen and Cobas, respectively. EGFR mutation subtypes, including del19, L858R, and others, were detected in 13.0%, 17.0%, and 2.5% of patients using Therascreen and 17.4%, 14.4%, and 1.5% of patients using Cobas, respectively. Conclusions No significant impact of switching from Therascreen to Cobas as the CDx test for EGFR mutations in clinical practice was observed. However, the detection pattern of the EGFR mutation subtypes between the two CDx tests was slightly different. Key points Significant findings of the study We examined the influence of changing the EGFR test in 1228 patients in total. The detection rate of EGFR mutations was similar. However, the detection pattern for EGFR subtype mutations was slightly different between the two tests. What this study adds Switching CDx tests from target polymerase chain reaction (PCR)‐ to next‐generation sequencing (NGS)‐based methods may lead to obvious changes in clinical practice. When the CDx test is required to change, the investigation of this influence is warranted in future studies.

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Section: Discussionsupporting

confidence: 65%

Clinical influence of switching companion diagnostic tests for EGFR‐TKs from Therascreen to Cobas v2

et al. 2021

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“…In patients with non-adenocarcinoma (ADC) non-small cell lung cancer carrying EFGR mutations, clinical studies have shown that the median OS of patients treated with EGFR-TKIs is significantly higher than patients not treated with EGFR-TKIs, and there is no significant difference in clinical characteristics between patients who respond to EGFR-TKIs and those who do not ( 8 ). Based on the literature review, the efficacy of EGFR-TKIs in lung SCC with EGFR mutant is lower than that in adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Osimertinib inhibits brain metastases and improves long-term survival in a patient with advanced squamous cell lung cancer: a case report and literatures review

Zhang,

Lin,

Yang

et al. 2023

Front. Oncol.

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BackgroundSquamous cell carcinoma (SCC) is one of the most common subtypes of non-small cell lung cancer, but its treatment options remain limited. Epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) have limited efficacy in the treatment of lung SCC. Here, we report an SCC patient who developed EGFR-T790M mutation and showed gefitinib resistance achieved an extremely long survival by taking Osimertinib alternatively.Case summaryA patient, 66-year-old non-smoking and drinking male with advanced SCC who was deemed inoperable at the time of diagnosis. The first genetic testing showed deletion mutation of exon 19 of EGFR. The patient was then treated with gefitinib with no significant efficacy. EGFR-T790M mutation was found in the second genetic test. The treatment regimen was changed to radiotherapy with Osimertinib, and the patient’s primary lesion and the brain metastases were well controlled.ConclusionThis typical case highlights the important role of Osimertinib in patients with SCC carrying EGFR mutations.

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“…Patients with MPE treated with TKIs often show an initial reduction, and almost 70% of them will experience recurrence requiring palliative intervention 15 – 17 . MPE often responds worse to EGFR TKIs than solid tumors 18 , 19 . One study reported significant accumulation of both erlotinib and OSI-420 in MPE with repeated dosing; thus, concentrations of TKIs in MPE do not appear to be responsible for unsatisfactory regression 20 .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of hyperthermic intrathoracic chemotherapy for initially diagnosed lung cancer with symptomatic malignant pleural effusion

Li¹,

Deng²,

Yan³

et al. 2023

Sci Rep

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Initially diagnosed malignant pleural effusion (MPE) has different systematic treatments, and defining the best drainage regimen according to the responsiveness of MPE to different systematic treatments is important. This study compared the efficacy of hyperthermic intrathoracic chemotherapy (HITHOC) and pleural catheter drainage (IPCD) for initially diagnosed lung cancer with symptomatic MPE. We retrospectively reviewed the medical records of initially diagnosed lung cancer patients with symptomatic MPE between January 2018 and May 2022. The patients were treated with IPCD or HITHOC for local control of MPE after diagnosis. Systematic regimens were conducted during 1 month according to guidelines after local treatment. Intrathoracic MPE progression-free survival (iPFS) and overall survival (OS) were calculated, Univariate and multivariable Cox-regression were used to identify factors associated with iPFS and OS. A total of 33 patients were evaluated; 10 (30.3%) patients received IPCD, and 23 (69.7%) patients received HITHOC. No difference in the MPE control rate at 1 month was found between the IPCD group (90%) and HITHOC group (95.7%). However, this control rate was significantly higher in the HITHOC group (69.6%) than in the IPCD group (30%) at 3 months (P = 0.035). Multivariate analysis showed that receiving tyrosine kinase inhibitors (TKIs) or chemotherapy was a significant protective factor for iPFS (HR = 0.376, 95% CI 0.214–0.659, P = 0.007) and OS (HR = 0.321, 95% CI 0.174–0.594, P < 0.001). According to subgroup analysis, among patients treated with TKIs, those who received HITHOC had longer iPFS and OS than those who received IPCD (P = 0.011 and P = 0.002, respectively), but this difference was not found in the palliative care subgroup. Moreover, no patients treated with chemotherapy showed reaccumulation of MPE. Systematic TKIs or chemotherapy prolonged iPFS and OS for those initially diagnosed with lung cancer with symptomatic MPE. HITHOC prolonged iPFS and OS for those treated with systematic TKIs.

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Key prognostic factors for EGFR-mutated non-adenocarcinoma lung cancer patients in the Japanese Joint Committee of Lung Cancer Registry Database

Cited by 8 publications

References 44 publications

Clinical influence of switching companion diagnostic tests for EGFR‐TKs from Therascreen to Cobas v2

Clinical influence of switching companion diagnostic tests for EGFR‐TKs from Therascreen to Cobas v2

Osimertinib inhibits brain metastases and improves long-term survival in a patient with advanced squamous cell lung cancer: a case report and literatures review

Efficacy of hyperthermic intrathoracic chemotherapy for initially diagnosed lung cancer with symptomatic malignant pleural effusion

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