Primary Tumor Resection for Stage IV Non-small-cell Lung Cancer Without Progression After First-Line Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Treatment: A Retrospective Case–Control Study

Kuo, Sy‐Yen; Chen, Pei-Hsing; Lu, Tzu-Pin; Chen, Ke-Cheng; Liao, Hsien-Chi; Tsou, Kuan-Chuan; Tsai, Tsung Han; Lin, Min; Hsu, Hsao‐Hsun; Chen, Jin‐Shing

doi:10.1245/s10434-022-11483-7

Cited by 6 publications

(9 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among the 11 final studies, which covered 1,313 patients, two were RCTs (n=194) ( 45 , 46 ), one was a phase II single-arm prospective study (n=59) ( 38 ), and eight were retrospective case-control studies (n=1,060) ( 36 , 37 , 39 - 44 ). There were 425 and 888 patients in the LT and TKI groups, respectively.…”

Section: Resultsmentioning

confidence: 99%

Additional local therapy before disease progression for EGFR-mutated advanced lung cancer: a systematic review and meta-analysis

Seong,

Kim,

Kim

et al. 2024

Transl Lung Cancer Res

View full text Add to dashboard Cite

Background International guidelines recommend the use of local therapy (LT) to limited progression in patients with epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). However, the use of LT before disease progression has not been extensively analyzed. This meta-analysis evaluates the efficacy and safety of administering additional LT in conjunction with first-line EGFR-tyrosine kinase inhibitors (TKIs) before disease progression in patients with EGFR-mutated advanced NSCLC. Methods We systematically searched PubMed, Embase, and the Cochrane Library for studies published up until May 31, 2023. The LT group consisted of patients who received first-line EGFR-TKIs in conjunction with additional LT, while the TKI group comprised participants treated with first-line EGFR-TKIs alone. Studies comparing the survival outcomes of the LT and TKI groups were included in this analysis. The primary outcomes were progression-free survival (PFS) and overall survival (OS). This review was registered on PROSPERO (registration number CRD42023439913). Results Among the 11 investigated studies covering 1,313 patients, the LT modalities included radiotherapy, surgery, and ablation therapy, which accounted for 91%, 27%, and 27% of the studies, respectively. The pooled hazard ratios of median PFS and OS were 0.34 [95% confidence interval (CI): 0.22–0.53; P<0.001] and 0.42 (95% CI: 0.36–0.48; P<0.001), respectively, which indicated significant benefits for the LT group compared to the TKI group. There was no significant difference between the LT and TKI groups (P=0.473) regarding the incidence of grade 3 or higher adverse events. Conclusions This study suggests that the strategic use of additional LT before disease progression is a promising approach for the treatment of EGFR-mutated advanced NSCLC.

show abstract

Section: Resultsmentioning

confidence: 99%

Additional local therapy before disease progression for EGFR-mutated advanced lung cancer: a systematic review and meta-analysis

Seong,

Kim,

Kim

et al. 2024

Transl Lung Cancer Res

View full text Add to dashboard Cite

show abstract

“…, p = 0.004) than patients treated with an EGFR-TKI alone [22]. Kuo et al reported that the median PFS increased to 29.6 (18.9-40.3) months in patients receiving an EGFR-TKI plus primary tumor resection, which was significantly longer than those who received EGFR-TKI alone (13.0 [11.8-14.2] months; p < 0.001) [28]. Chen et al enrolled a total of 29 patients with EGFR-mutant advanced lung adenocarcinomas who also underwent surgical resection; the median PFS after surgery was 36.4 months, and the median OS was still not reached [27].…”

Section: Discussionmentioning

confidence: 99%

“…Tseng et al reported that patients with EGFR -mutant lung cancer treated with primary tumor resection, in addition to a first-line EGFR-TKI, experienced significantly longer PFS (25.1 months [95% CI: 16.6–33.7 months] vs. 9.4 months [95% CI: 8.4–10.4 months]; adjusted HR [95% CI]: 0.40 [0.30–0.54], p < 0.001) and OS (56.8 months [95% CI: 36.3–77.2 months] vs. 31.8 months [95% CI: 28.2–35.4 months]; adjusted HR [95% CI]: 0.57 [0.39–0.84], p = 0.004) than patients treated with an EGFR-TKI alone [ 22 ]. Kuo et al reported that the median PFS increased to 29.6 (18.9–40.3) months in patients receiving an EGFR-TKI plus primary tumor resection, which was significantly longer than those who received EGFR-TKI alone (13.0 [11.8–14.2] months; p < 0.001) [ 28 ]. Chen et al enrolled a total of 29 patients with EGFR -mutant advanced lung adenocarcinomas who also underwent surgical resection; the median PFS after surgery was 36.4 months, and the median OS was still not reached [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Palma et al reported a phase II trial (SABR-COMET trial), showing that SABR-based LCT resulted in prolonged PFS and OS in several solid tumors, including lung cancer, compared with observation only [ 26 ]. Surgical interventions also may provide extra benefits when combined with standard systemic chemotherapy in patients with advanced NSCLC [ 22 , 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a study by Elamin et al, patients with EGFR -mutant NSCLC treated with a first-line EGFR-TKI followed by LCT had significantly longer PFS when compared with those treated with treatment with a first-line EGFR-TKI alone [ 19 ]. Several smaller-scale trials in Taiwan also demonstrated that patients receiving an EGFR-TKI together with local surgical resection to treat primary lung tumors also experienced significantly longer PFS than those receiving an EGFR-TKI alone [ 22 , 27 , 28 ]. A meta-analysis of these available data showed that LCT might improve PFS and OS in metastatic NSCLC patients, without increasing the risks of high-grade adverse effects [ 23 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Local Consolidative Therapy May Have Prominent Clinical Efficacy in Patients with EGFR-Mutant Advanced Lung Adenocarcinoma Treated with First-Line Afatinib

Tsai

Hung

et al. 2023

Cancers

View full text Add to dashboard Cite

Afatinib is an irreversible tyrosine kinase inhibitor (TKI) targeting the epidermal growth factor receptor (EGFR), which is utilized for the treatment of patients with advanced lung cancer that harbors EGFR mutations. No studies have evaluated the clinical efficacy of LCT in patients treated with first-line afatinib. In this study, we retrospectively enrolled patients with advanced lung adenocarcinomas harboring susceptible EGFR mutations who were diagnosed and treated with first-line afatinib in three hospitals. A total of 254 patients were enrolled, including 30 (12%) patients who received LCT (15 patients received definitive radiotherapy for the primary lung mass and 15 patients received curative surgery). Patients who received LCT had a significantly longer PFS than those who did not (median PFS: 32.8 vs. 14.5 months, p = 0.0008). Patients who received LCT had significantly longer OS than those who did not (median OS: 67.1 vs. 34.5 months, p = 0.0011). Multivariable analysis showed LCT was an independent prognostic factor for improved PFS (adjusted hazard ratio [aHR] [95% confidence interval (CI)]: 0.44 [0.26–0.73], p = 0.0016) and OS (aHR [95% CI]: 0.26 [0.12–0.54], p = 0.0004). The analyses using propensity score-weighting showed consistent results. We conclude that LCT may improve clinical outcomes, in terms of PFS and OS, in patients with advanced EGFR-mutant lung adenocarcinomas who are treated with first-line afatinib.

show abstract

Primary tumor resection improves survival benefit of stage IVB cervical carcinoma: a new perspective

Zhang

et al. 2023

J Cancer Res Clin Oncol

View full text Add to dashboard Cite

Primary Tumor Resection for Stage IV Non-small-cell Lung Cancer Without Progression After First-Line Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitor Treatment: A Retrospective Case–Control Study

Cited by 6 publications

References 35 publications

Additional local therapy before disease progression for EGFR-mutated advanced lung cancer: a systematic review and meta-analysis

Additional local therapy before disease progression for EGFR-mutated advanced lung cancer: a systematic review and meta-analysis

Local Consolidative Therapy May Have Prominent Clinical Efficacy in Patients with EGFR-Mutant Advanced Lung Adenocarcinoma Treated with First-Line Afatinib

Primary tumor resection improves survival benefit of stage IVB cervical carcinoma: a new perspective

Contact Info

Product

Resources

About