Postoperative tegafur–uracil for stage I lung adenocarcinoma: first real-world data with an exploratory subgroup analysis

Miyata, Ryo; Hamaji, Masatsugu; Nakakura, Akiyoshi; Morita, Satoshi; Shimazu, Yumeta; Ishikawa, Masashi; Kayawake, Hidenao; Menju, Toshi; Sakaguchi, Yasuyoshi; Sonobe, Makoto; Takahashi, Mamoru; Aoyama, Akihiro; Sumitomo, Ryota; Huang, Cheng-long; Kono, Tomoya; Miyahara, Ryoji; Matsumoto, Akira; Katakura, Hiromichi; Fukada, Takahisa; Sakai, Hiroaki; Kobayashi, Masashi; Okumura, Norihito; Date, Naoki; Fujinaga, Takuji; Miyamoto, Ei; Nakagawa, Tatsuo; Date, Hiroshi

doi:10.1007/s00595-022-02546-z

Cited by 2 publications

(3 citation statements)

References 21 publications

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“… 11) A recent multicenter real-world data study of patients with resected stage I LUAD with a tumor diameter of >2 cm to ≤5 cm in Japan reported that the administration of UFT did not significantly improve OS. 19) This result supports the results observed in the entire cohort of our study. However, this study did not examine the effects of UFT with or without EGFR mutations.…”

Section: Discussionsupporting

confidence: 92%

Effect of Tegafur–Uracil in Resected Stage IB Lung Adenocarcinoma According to Presence or Absence of Epidermal Growth Factor Receptor Gene Mutation: A Retrospective Cohort Study

Aoki,

Miyata,

Kamimura

et al. 2024

ATCS

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Purpose: Tegafur–uracil (UFT) is the standard postoperative adjuvant therapy for stage IB lung adenocarcinoma (LUAD) in Japan. This study aimed to determine whether UFT is effective in stage IB LUAD with and without epidermal growth factor receptor ( EGFR ) mutations. Methods: This retrospective study included 169 patients with stage IB LUAD who underwent complete resection at our department between 2010 and 2021. We investigated the clinicopathological and prognostic impact of EGFR mutations as well as the postoperative use of UFT. Results: EGFR mutation-positive cases tended to show a higher cumulative recurrence rate than EGFR mutation-negative cases (p = 0.081), while overall survival was comparable between the groups (p = 0.238). In the entire cohort, UFT administration was not an independent prognostic factor in the multivariate regression analysis (p = 0.112). According to a stratification analysis, UFT administration was independently associated with favorable overall survival (p = 0.031) in EGFR mutation-negative cases, while it was not associated with recurrence-free survival (p = 0.991) or overall survival (p = 0.398) in EGFR mutation-positive cases. Conclusion: UFT administration can improve the prognosis of EGFR mutation-negative LUAD but not EGFR mutation-positive LUAD. Thus, clinical trials of adjuvant-targeted therapy for EGFR mutation-positive stage IB LUAD should also be conducted in Japan.

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Section: Discussionsupporting

confidence: 92%

Effect of Tegafur–Uracil in Resected Stage IB Lung Adenocarcinoma According to Presence or Absence of Epidermal Growth Factor Receptor Gene Mutation: A Retrospective Cohort Study

Aoki,

Miyata,

Kamimura

et al. 2024

ATCS

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“…Two earlier prospective trials reported a survival benefit of adjuvant oral UFT treatment in patients with stage IB adenocarcinoma and stage I to III NSCLC 6,19 . A recent retrospective real‐world study in Japan demonstrated that the use of oral UFT after complete resection of stage I NSCLC could improve OS and RFS, especially in patients aged 45 to 75 years, and the results were consistent with previous clinical trials 32 . However, the evidence of comparing adjuvant oral UFT with adjuvant intravenous chemotherapy for stage I to IIIA NSCLC remained limited, and the number of cases in these trials was small 6,19 .…”

Section: Discussionsupporting

confidence: 79%

“… 6 , 19 A recent retrospective real‐world study in Japan demonstrated that the use of oral UFT after complete resection of stage I NSCLC could improve OS and RFS, especially in patients aged 45 to 75 years, and the results were consistent with previous clinical trials. 32 However, the evidence of comparing adjuvant oral UFT with adjuvant intravenous chemotherapy for stage I to IIIA NSCLC remained limited, and the number of cases in these trials was small. 6 , 19 Additionally, a previous clinical trial using paclitaxel plus carboplatin as an experimental regimen did not show an advantage as adjuvant therapy in patients with stage IB disease.…”

Section: Discussionmentioning

confidence: 99%

Oral uracil–tegafur compared with intravenous chemotherapy as adjuvant therapy for resected early‐stage non‐small cell lung cancer patients

Liang

Chang

et al. 2023

Cancer Medicine

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BackgroundStudies comparing the effectiveness of either adjuvant oral uracil‐tegafur (UFT) or intravenous chemotherapy on early‐stage (stage I and II) non‐small cell lung cancer (NSCLC) patients treated with complete surgical treatment remain limited.MethodsFrom January 2011 to December 2017, patients with early‐stage NSCLC (defined as tumor size >3 cm without mediastinal lymph node involvement or any distant metastasis) receiving either adjuvant oral UFT or intravenous chemotherapy after surgical resection were identified from the Taiwan Cancer Registry. Overall survival (OS) and relapse‐free survival (RFS) were the primary and secondary outcomes, respectively. Propensity matching was used for controlling confounders.ResultsA total of 840 patients receiving adjuvant therapy after surgery (including 595 oral UFT and 245 intravenous chemotherapy) were enrolled. Before matching, patients using oral UFT had significantly longer OS (HR: 0.69, 95% CI: 0.49–0.98, p = 0.0387) and RFS (HR: 0.79, 95% CI: 0.61–0.97, p = 0.0392) than those with intravenous chemotherapy. A matched cohort of 352 patients was created using 1:1 propensity score‐matching. In the Cox regression analysis, the UFT and the matched chemotherapy groups had similar OS (HR: 0.80, 95% CI: 0.48–1.32, p = 0.3753) and RFS (HR: 0.98, 95% CI: 0.72–1.34, p = 0.9149). Among subgroup analysis, oral UFT use was associated with longer RFS among the subgroups of non‐drinker (HR: 0.66, 95% CI: 0.34–0.99, p = 0.0478) and patients with stage IB disease (HR: 0.67, 95% CI: 0.42–0.97, p = 0.0341).ConclusionsThis population‐based study in the real‐world setting of Taiwan demonstrates comparable effectiveness between oral UFT and intravenous chemotherapy in terms of clinical outcomes for early‐stage NSCLC patients after surgery.

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Postoperative tegafur–uracil for stage I lung adenocarcinoma: first real-world data with an exploratory subgroup analysis

Cited by 2 publications

References 21 publications

Effect of Tegafur–Uracil in Resected Stage IB Lung Adenocarcinoma According to Presence or Absence of Epidermal Growth Factor Receptor Gene Mutation: A Retrospective Cohort Study

Effect of Tegafur–Uracil in Resected Stage IB Lung Adenocarcinoma According to Presence or Absence of Epidermal Growth Factor Receptor Gene Mutation: A Retrospective Cohort Study

Oral uracil–tegafur compared with intravenous chemotherapy as adjuvant therapy for resected early‐stage non‐small cell lung cancer patients

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