Role of gefitinib in the targeted treatment of non-small-cell lung cancer in Chinese patients

Li, Mengjiao; He, Qiang; Li, Mei; Luo, Feng; Guan, Yong-Song

doi:10.2147/ott.s80635

Cited by 8 publications

(7 citation statements)

References 81 publications

(87 reference statements)

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“…Furthermore, its incidence and mortality are rapidly increasing; the estimated number of deaths due to lung cancer in China rose from 493,348 in 2008 to 529,153 in 2011 2. Unfortunately, the majority of patients with lung cancer in China are diagnosed at an advanced stage, thus precluding the possibility of surgery with curative intent 2,3. The mainstay of treatment for advanced-stage disease is chemotherapy; however, the effectiveness of systemic platinum-doublet chemotherapy has plateaued over recent years and remains suboptimal.…”

Section: Introductionmentioning

confidence: 99%

Afatinib versus gemcitabine/cisplatin for first-line treatment of Chinese patients with advanced non-small-cell lung cancer harboring <em>EGFR </em>mutations: subgroup analysis of the LUX-Lung 6 trial

Wu¹,

Xu²,

Feng³

et al. 2018

OTT

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IntroductionNon-small-cell lung cancer (NSCLC) is the leading cause of cancer death in China. Four epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitors – afatinib, erlotinib, icotinib, and gefitinib – are available for first-line treatment of NSCLC in China; however, there are few data to guide treatment choice. The Phase III LUX-Lung 6 trial compared afatinib with platinum-based chemotherapy for first-line treatment of patients from Southeast Asia with EGFR mutation-positive advanced NSCLC. This post hoc analysis assessed the findings from LUX-Lung 6 in Chinese patients.Clinical trial registrationClinicalTrials.gov: NCT01121393.Materials and methodsPreviously untreated patients with EGFR mutation-positive stage IIIB/IV lung adenocarcinoma were randomized 2:1 to receive afatinib or ≤6 cycles of gemcitabine/ cisplatin. The key outcomes were progression-free survival (PFS; primary), objective response rate, disease control rate, overall survival (OS), duration of response and disease control, patient-reported outcomes, and safety. Three hundred and twenty-seven patients from mainland China were treated (89.8% of overall LUX-Lung 6 population; afatinib 217, gemcitabine/cisplatin 110).ResultsPFS was significantly longer with afatinib than gemcitabine/cisplatin (median 11.0 versus 5.6 months; hazard ratio [HR], 0.30 [95% CI, 0.21, 0.43]; P,0.0001). Overall, there was no significant difference in OS between treatment arms; however, in a subgroup analysis, afatinib significantly improved OS versus gemcitabine/cisplatin in patients with an EGFR Del19 mutation (median 31.6 versus 16.3 months; HR, 0.61 [95% CI, 0.41, 0.91]; P=0.0146). Afatinib was well tolerated, with most treatment-related adverse events (TRAEs) being of grade 1 or 2 severity. The most common grade 3/4 TRAEs with afatinib were rash/acne (15.9%/0.5%), stomatitis (6.1%/0%), and diarrhea (5.6%/0%). TRAEs leading to permanent discontinuation were reported in 12 patients (5.6%) receiving afatinib and 43 (41.7%) receiving gemcitabine/cisplatin. Afatinib significantly improved PFS compared with standard first-line chemotherapy in Chinese patients with EGFR mutation-positive NSCLC and demonstrated a manageable safety profile.ConclusionThe findings support the rationale for using afatinib as a first-line treatment option for this patient population.

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Section: Introductionmentioning

confidence: 99%

Afatinib versus gemcitabine/cisplatin for first-line treatment of Chinese patients with advanced non-small-cell lung cancer harboring <em>EGFR </em>mutations: subgroup analysis of the LUX-Lung 6 trial

Wu¹,

Xu²,

Feng³

et al. 2018

OTT

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“…The decoding of the lung cancer genome has led to therapeutic targeting of key gene mutations driving cancer initiation and progression, an approach successfully applied to clinical practice and demonstrating a significant response ( 6 , 7 ). Aside from contributing to genetic mutations, various stromal cells and cellular components from tumor microenvironments also contribute to NSCLC development.…”

Section: Introductionmentioning

confidence: 99%

Adiponectin inhibits migration and invasion by reversing epithelial‑mesenchymal transition in non‑small cell lung carcinoma

et al. 2018

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Adiponectin is the most abundant adipokine in the tumor microenvironment. The role of this protein in tumor progression, however, remains controversial. In the present study, we aimed to investigate the effects of adiponectin on the abilities of migration and invasion in non-small cell lung carcinoma (NSCLC). Using NSCLC cell lines, we examined the effects of adiponectin on cell migration and invasion using Transwell assays. Expression of epithelial-mesenchymal transition markers was examined via microscopy and western blotting. We also performed a knockdown of Twist, AdipoR1 and AdipoR2 in NSCLC cells with siRNAs. The addition of adiponectin to NSCLC cells inhibited both the migration and invasion abilities. Furthermore, we found that NSCLC cells displayed increased epithelial marker expression and downregulation of mesenchymal marker expression following adiponectin administration. Twist AdipoR1 and AdipoR2 knockdown reversed the inhibitory effects of adiponectin on migration and invasion in NSCLC and epithelial-mesenchymal transition. Exogenous adiponectin significantly impaired the migratory and invasive capacities of NSCLC cells through reversal of EMT, suggesting that adiponectin may be a novel promising therapeutic approach against NSCLC.

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“…While the incidence of lung cancer has declined in some regions like North America and Europe, it is still high in China with the incidence rate of 733.3 per 100,000 in 2015 [2]. Moreover, with an annual growth rate of 26.9%, the expected number of cases of lung cancer will reach 100 million in 2025, indicating that China might have the largest population of lung carcinoma patients around the world [3]. …”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Brucea javanica Oil Emulsion Injection as Adjunctive Therapy for Advanced Non‐Small‐Cell Lung Cancer: A Meta‐Analysis

Jiang

et al. 2016

Evidence-Based Complementary and Alternative Medicine

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Purpose. To evaluate the efficacy of Brucea javanica oil emulsion injection (BJOEI) in patients with advanced non-small-cell lung cancer (NSCLC) during chemotherapy. Method. Electronic database of EMBASE and PubMed and the conference proceeding of ASCO, CNKI, CBMdisc, VIP, and Wanfang database were searched to select RCTs comparing BJOEI plus chemotherapy with chemotherapy alone in the treatment of advanced NSCLC, until June 1, 2016. Two reviewers independently performed the analysis according to the inclusion and exclusion criteria. Review Manager 5.3 and STATA 12.0 were employed for data analysis. Result. Twenty-one studies including 2234 cases were included. The pooled result indicated that there were significant differences in ORR (RR = 1.25; 95% CI: 1.14–1.36; P < 0.00001), improvement of QOL (RR = 1.87; 95% CI: 1.63–2.15; P < 0.00001), nausea and vomiting (RR = 0.67; 95% CI: 0.46–0.98; P = 0.04), leukopenia (RR = 0.63; 95% CI: 0.52–0.75; P < 0.00001), but there was no difference in thrombocytopenia (RR = 0.78; 95% CI: 0.49–1.23; P = 0.29). Begg's funnel plot and Egger's test indicated that no publication bias was found. The sensitivity analysis suggested the stability of the pooled result. Conclusion. The addition of BJOEI can enhance efficacy, improve QOL, and decrease incidence of nausea and vomiting and leukopenia for advanced NSCLC patients. However, higher quality RCTs are needed to further confirm this finding.

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Role of gefitinib in the targeted treatment of non-small-cell lung cancer in Chinese patients

Cited by 8 publications

References 81 publications

Afatinib versus gemcitabine/cisplatin for first-line treatment of Chinese patients with advanced non-small-cell lung cancer harboring <em>EGFR </em>mutations: subgroup analysis of the LUX-Lung 6 trial

Afatinib versus gemcitabine/cisplatin for first-line treatment of Chinese patients with advanced non-small-cell lung cancer harboring <em>EGFR </em>mutations: subgroup analysis of the LUX-Lung 6 trial

Adiponectin inhibits migration and invasion by reversing epithelial‑mesenchymal transition in non‑small cell lung carcinoma

The Efficacy of Brucea javanica Oil Emulsion Injection as Adjunctive Therapy for Advanced Non‐Small‐Cell Lung Cancer: A Meta‐Analysis

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