Lung Cancer in Malaysia

Rajadurai, Pathmanathan; How, Soon Hin; Liam, Chong Kin; Sachithanandan, Anand; Soon, Sing Yang; Tho, Lye Mun

doi:10.1016/j.jtho.2019.10.021

Cited by 26 publications

(22 citation statements)

References 8 publications

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“… 1 , 2 The lower prevalence can probably be attributed to the low rate of ALK -translocation testing in patients with adenocarcinoma in Malaysia. This is despite ALK translocation being common among adenocarcinoma patients in Malaysia (13% based on earlier data in selected patients with negative EGFR mutations) 34 and ALK tests being freely available in public hospitals. 34 Testing for ALK translocation is not a priority among physicians, mainly because of the expense of ALK inhibitors, especially among government-supported patients.…”

Section: Discussionmentioning

confidence: 99%

“…This is despite ALK translocation being common among adenocarcinoma patients in Malaysia (13% based on earlier data in selected patients with negative EGFR mutations) 34 and ALK tests being freely available in public hospitals. 34 Testing for ALK translocation is not a priority among physicians, mainly because of the expense of ALK inhibitors, especially among government-supported patients. 35 The lack of access to treatment options for ALK mutations will affect testing rates.…”

Section: Discussionmentioning

confidence: 99%

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Real-World Treatment and Outcomes of ALK-Positive Metastatic Non–Small Cell Lung Cancer in a Southeast Asian Country

Poh

How

et al. 2023

CMAR

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Purpose Anaplastic lymphoma kinase (ALK) inhibitors are associated with good overall survival (OS) for ALK-positive metastatic non–small cell lung cancer (NSCLC). However, these treatments can be unavailable or limited by financial constraints in developing countries. Using data from a nationwide lung cancer registry, the present study aimed to identify treatment patterns and clinical outcomes of ALK-positive NSCLC in Malaysia. Methods This retrospective study examined data of patients with ALK-positive NSCLC from 18 major hospitals (public, private, or university teaching hospitals) throughout Malaysia between January 1, 2015 and December 31, 2020 from the National Cardiovascular and Thoracic Surgical Database (NCTSD). Data on baseline characteristics, treatments, radiological findings, and pathological findings were collected. Overall survival (OS) and time on treatment (TOT) were calculated using the Kaplan–Meier method. Results There were 1581 NSCLC patients in the NCTSD. Based on ALK gene-rearrangement test results, only 65 patients (4.1%) had ALK-positive advanced NSCLC. Of these 65 patients, 59 received standard-of-care treatment and were included in the analysis. Crizotinib was the most commonly prescribed ALK inhibitor, followed by alectinib and ceritinib. Patients on ALK inhibitors had better median OS (62 months for first-generation inhibitors, not reached at time of analysis for second-generation inhibitors) compared to chemotherapy (27 months), but this was not statistically significant ( P =0.835) due to sample-size limitations. Patients who received ALK inhibitors as first-line therapy had significantly longer TOT (median of 11 months for first-generation inhibitors, not reached for second-generation inhibitors at the time of analysis) compared to chemotherapy (median of 2 months; P <0.01). Conclusion Patients on ALK inhibitors had longer median OS and significantly longer TOT compared to chemotherapy, suggesting long-term benefit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-World Treatment and Outcomes of ALK-Positive Metastatic Non–Small Cell Lung Cancer in a Southeast Asian Country

Poh

How

et al. 2023

CMAR

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“…EGFR mutations represent the most commonly detected genetic alteration in NSCLC, with a prevalence range of 40–60% among Asians [ 34 – 36 ]. NSCLC patients who received epidermal growth factor receptor tyrosine kinase inhibitors (TKI) demonstrated excellent responses and achieved longer progression free survival [ 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Analytical and clinical validation of a custom 15-gene next-generation sequencing panel for the evaluation of circulating tumor DNA mutations in patients with advanced non-small-cell lung cancer

Chow

Abidin²,

Kow

et al. 2022

PLoS ONE

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Background This is a pilot proof-of-concept study to evaluate the utility of a custom 15-gene circulating tumor DNA (ctDNA) panel as a potential companion molecular next-generation sequencing (NGS) assay for identifying somatic single nucleotide variants and indels in non-small-cell lung cancer (NSCLC) patients. The custom panel covers the hotspot mutations in EGFR, KRAS, NRAS, BRAF, PIK3CA, ERBB2, MET, KIT, PDGFRA, ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 genes which serve as biomarkers for guiding treatment decisions in NSCLC patients. Method The custom 15-gene ctDNA NGS panel was designed using ArcherDX Assay Designer. A total of 20 ng or 50 ng input ctDNA was used to construct the libraries. The analytical performance was evaluated using reference standards at different allellic frequencies (0.1%, 1%, 5% and parental). The clinical performance was evaluated using plasma samples collected from 10 treatment naïve advanced stage III or IV NSCLC patients who were tested for tissue EGFR mutations. The bioinformatics analysis was performed using the proprietary Archer Analysis Software. Results For the analytical validation, we achieved 100% sensitivity and specificity for the detection of known mutations in the reference standards. The limit of detection was 1% allelic frequency. Clinical validation showed that the clinical sensitivity and specificity of the assay for detecting EGFR mutation were 83.3% and 100% respectively. In addition, the NGS panel also detected other mutations of uncertain significance in 6 out of 10 patients. Conclusion This preliminary analysis showed that the custom 15-gene ctDNA NGS panel demonstrated good analytical and clinical performances for the EGFR mutation. Further studies incorporating the validation of other candidate gene mutations are warranted.

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“…Among the three sites with lower proportions of testing, the reasons were unaffordability of performing the test itself and/or the unaffordability of ALK TKIs, other than for patients in Singapore. 47 , 48 , 49 , 50 , 51 …”

Section: Discussionmentioning

confidence: 99%

Diagnostic work-up and systemic treatment for advanced non-squamous non-small-cell lung cancer in four Southeast Asian countries

et al. 2022

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Lung Cancer in Malaysia

Cited by 26 publications

References 8 publications

Real-World Treatment and Outcomes of ALK-Positive Metastatic Non–Small Cell Lung Cancer in a Southeast Asian Country

Real-World Treatment and Outcomes of ALK-Positive Metastatic Non–Small Cell Lung Cancer in a Southeast Asian Country

Analytical and clinical validation of a custom 15-gene next-generation sequencing panel for the evaluation of circulating tumor DNA mutations in patients with advanced non-small-cell lung cancer

Diagnostic work-up and systemic treatment for advanced non-squamous non-small-cell lung cancer in four Southeast Asian countries

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