scholarly journals Outcomes of Elderly Patients Who Receive Combined Modality Therapy for Locally Advanced Non–Small-Cell Lung Cancer

2017 ◽  
Vol 18 (1) ◽  
pp. e21-e26 ◽  
Author(s):  
Mark Zaki ◽  
Michael Dominello ◽  
Gregory Dyson ◽  
Shirish Gadgeel ◽  
Antoinette Wozniak ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Elderly Patients ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Combined Modality

Outcomes by EGFR, KRAS, and ALK Genotype After Combined Modality Therapy for Locally Advanced Non–Small-Cell Lung Cancer

2018 ◽  
pp. 1-18
Author(s):  
Raymond H. Mak ◽  
Gretchen Hermann ◽  
Hugo J. Aerts ◽  
Elizabeth H. Baldini ◽  
Aileen B. Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Multivariable Analysis ◽  
Distant Metastases ◽  
Small Cell ◽  
Small Cell Lung ◽  
Combined Modality

Purpose In 699 patients with locally advanced non–small-cell lung cancer (NSCLC) treated with radiation therapy as part of combined modality therapy, we compared outcomes among genotyped and ungenotyped patients and by tumor genotype status ( EGFR, KRAS, and ALK). Patients and Methods Genotyping was performed in 250 patients: EGFR+ (19%), KRAS+ (32%), ALK+ (9%), and wild type (WT−/−/−; 40%). Outcomes were analyzed using the Kaplan-Meier method and Cox regression. Results With a median follow-up of 48.2 months among genotyped patients, median overall survival (OS) was significantly longer for EGFR+ and ALK+ compared with KRAS+ and WT−/−/− (55.8 months v not reached v 28.0 v 33.2 months; P = .02). There was no difference in progression-free survival (median, 15.3 v 13.7 v 13.0 v 14.5 months; P = .47) or in freedom from distant metastases by genotype (3-year estimates: 42% v 49% v 27% v 25%; P = .25). There was higher freedom from locoregional recurrence (LRR) for EGFR+ tumors and lower freedom from LRR in ALK+ tumors, compared with KRAS+ and WT−/−/− tumors (3-year: 77% v 38% v 49% v 46%). In multivariable analysis, ALK+ remained associated with increased OS (HR, 0.32; 95% CI, 0.12 to 0.87; P = .03), and EGFR+ was associated with decreased LRR (HR, 0.47; 95% CI, 0.24 to 0.92; P = .03). Analysis of post-recurrence survival demonstrated that EGFR+/ ALK+ patients treated with appropriate tyrosine kinase inhibitors had higher OS compared with other groups. Conclusion In this series of locally advanced NSCLC treated with combined modality therapy, EGFR+ and ALK+ were associated with higher OS, whereas LRR was lower in EGFR+ patients, and the risk of distant metastases was high in all subgroups. The outcomes and patterns of failure in genotypic subgroups of NSCLC from this study can inform the design of future trials integrating targeted therapies.

Combined Modality Therapy for Locally Advanced Non-Small Cell Lung Cancer

2003 ◽  
Vol 35 (5) ◽  
pp. 373-382
Author(s):  
L Chinsoo Cho ◽  
J Michael Dimaio ◽  
Randall Hughes ◽  
Phuc Nguyen ◽  
Paula Anderson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combined Modality Therapy ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Combined Modality
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