Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non–Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies

Stinchcombe, Thomas E.; Zhang, Ying; Vokes, Everett E.; Schiller, Joan H.; Bradley, Jeffrey D.; Kelly, Karen; Schild, Steven E.; Movsas, Benjamin; Clamon, Gerald H.; Govindan, Ramaswamy; Blumenschein, George R.; Socinski, Mark A.; Ready, Neal; Akerley, Wallace; Cohen, Harvey Jay; Pang, Herbert; Wang, Xiaofei

doi:10.1200/jco.2016.71.4758

Cited by 71 publications

(54 citation statements)

References 48 publications

(7 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings concord and confirm with previous findings that radiation 30 and chemoradiotherapy carry a worse OS with more toxicity and a higher rate of death during treatment, particularly in older patients 31 . Our work thus builds upon recent evidence suggesting radiation therapy be reconsidered in patients with lung adenocarcinoma.…”

Section: Discussionsupporting

confidence: 92%

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Ruíz-Cordero

Khanna

et al. 2019

Preprint

View full text Add to dashboard Cite

Introduction: Gene expression profiling has consistently identified three molecular subtypes of lung adenocarcinoma that have prognostic implications. To facilitate stratification of patients with this disease into similar molecular subtypes, we developed and validated a simple, mutually exclusive classification. Methods: Mutational status of EGFR, KRAS, and TP53 was used to define six mutually exclusive molecular subtypes. A development cohort of 283 cytology specimens of lung adenocarcinoma was used to evaluate the associations between the proposed classification and clinicopathologic variables including demographic characteristics, smoking history, fluorescence in situ hybridization and molecular results. For validation and prognostic assessment, 63 of the 283 cytology specimens with available survival data were combined with a separate cohort of 428 surgical pathology specimens of lung adenocarcinoma. Results: The proposed classification yielded significant associations between these molecular subtypes and clinical and prognostic features. We found better overall survival in patients who underwent surgery and had tumors enriched for EGFR mutations.Worse overall survival was associated with older age, stage IV disease, and tumors with co-mutations in KRAS and TP53. Interestingly, neither chemotherapy nor radiation therapy showed benefit to overall survival. Conclusions: The mutational status of EGFR, KRAS, and TP53 can be used to easily classify lung adenocarcinoma patients into six subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously. BackgroundLung cancer is the main cause of cancer-related mortality in both men and women 1-3 . Lung adenocarcinoma accounts for approximately 40% of lung cancer cases 4-6 . Gene expression profiling of lung adenocarcinomas has consistently identified three molecular subtypes with prognostic implications 7-14 . The initial molecular classification of lung adenocarcinomas included the bronchoid, magnoid, and squamoid subtypes 11,15 . However, after comprehensive molecular profiling of a cohort of lung adenocarcinomas, The Cancer Genome Atlas Research Network proposed an updated nomenclature for this molecular classification that encompasses previous histopathologic, anatomic, Patient selection for development cohortWe retrospectively reviewed our institutional database for patients treated between May 1, 2010, and October 31, 2015, to identify cytologic specimens of patients with lung adenocarcinoma. Patients with TTF1-negative non-small cell lung cancer, small cell lung cancer, large cell carcinoma, squamous carcinoma, and poorly differentiated carcinoma not otherwise specified were excluded. We reviewed the patients' medical records for demographic characteristics, clinical information, fluorescence in situ hybridization (FISH) results for ALK, ROS1, MET, and/or RET, and mutation profiling data derived by next-generation sequenci...

show abstract

Section: Discussionsupporting

confidence: 92%

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Ruíz-Cordero

Khanna

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

Section: No Major Differences Were Observed Between the Stru And Egfrsupporting

confidence: 92%

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Ruíz-Cordero

Khanna

et al. 2019

Preprint

View full text Add to dashboard Cite

Disclaimers:The authors have nothing to disclose.The mutational status of EGFR, KRAS, and TP53 can be used to easily classify lung adenocarcinoma patients into six subtypes that show a relationship with prognosis, especially in patients who underwent surgery, and these subtypes are similar to classifications based on more complex genomic methods reported previously. than sTRU and sPP when including all tumor stages. C) OS does not significantly differ between the sTRU and EGFR/TP53 subtypes. D) OS does significantly differ between the sPP and KRAS/TP53 subtypes. The number of patients and the log-rank test p value are shown at the bottom of each plot. Table 1. Demographic and clinicopathologic characteristics in the development cohort. Variable Value Sex, n (%) Male 132 (46.6) Female 151 (53.4) Age, median (range) 65.4 y (27.5-90.2 y) Race/ethnicity, n (%) Caucasian 215 (76.0) Asian 27 (9.5) Black 19 (6.7) Hispanic 21 (7.4) Unknown 1 (0.3) Smoking status, n (%) Never-smoker 64 (22.6) Former smoker 136 (48.1) Current smoker 82 (29.0) Unknown 1 (0.3) Vital status, n (%) Alive 172 (60.8) Deceased 111 (39.2) Molecular platform, n (%) NGS 218 (77) PCR* 55 (19.5) Not done 10 (3.5) Molecular subtype, n (%) (n=233) sTRU -EGFR (%) 11 (52.4) Acinar, n (%)121 0.012 0 78 (64.5) 17 (77.3) 28 (80.0) 8 (57.1) 4 (40.0) 5 (45.5) 7 (87.5) 9 (42.9) 1 43 (35.5) 5 (22.7) 7 (20.0) 6 (42.9) 6 (60.0) 6 (54.5) 1 (12.5) 12 (57.1) Micro/papillary, n (%) 121 0.175 0 106 (87.6) 21 (95.5) 31 (88.6) 14 (100.0) 7 (70.0) 10 (90.9) 6 (75.0) 17 (81.0) 1 15 (12.4) 1 (4.5) 4 (11.4) 0 (0.0) 3 (30.0) 1 (9.1) 2 (25.0) 4 (19.0) Solid, n (%) 121 0.143 0 103 (85.1) 20 (90.9) 30 (85.7) 11 (78.6) 9 (90.0) 6 (54.5) 8 (100.0) 19 (90.5)

show abstract

“…1) (Table 1). 8,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]46 Patient characteristics are found in Table 2. The average patient age was 62 years and 64% were men.…”

Section: Resultsmentioning

confidence: 99%

Exploring Radiotherapy Targeting Strategy and Dose: A Pooled Analysis of Cooperative Group Trials of Combined Modality Therapy for Stage III NSCLC

Schild

Pang

Fan

et al. 2018

Journal of Thoracic Oncology

Self Cite

View full text Add to dashboard Cite

show abstract

Pooled Analysis of Individual Patient Data on Concurrent Chemoradiotherapy for Stage III Non–Small-Cell Lung Cancer in Elderly Patients Compared With Younger Patients Who Participated in US National Cancer Institute Cooperative Group Studies

Cited by 71 publications

References 48 publications

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Simplified Molecular Classification of Lung Adenocarcinomas Based on EGFR, KRAS, and TP53 Mutations

Exploring Radiotherapy Targeting Strategy and Dose: A Pooled Analysis of Cooperative Group Trials of Combined Modality Therapy for Stage III NSCLC

Contact Info

Product

Resources

About