scholarly journals EGFR-TKI therapy for patients with brain metastases from non-small-cell lung cancer: a pooled analysis of published data

2014 ◽  
pp. 2075 ◽  
Author(s):  
Conghua Xie ◽  
Yun Fan ◽  
Xiaoling Xu
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Pooled Analysis ◽  
Small Cell ◽  
Published Data ◽  
Small Cell Lung ◽  
Egfr Tki

scholarly journals MET-8 Chemotherapy alone for brain metastases from small cell lung cancer -comparison with EGFR-TKI-

2021 ◽  
Vol 3 (Supplement_6) ◽  
pp. vi26-vi26
Author(s):  
Toshihiko Iuchi ◽  
Masato Syngyoji ◽  
Hironori Ashinuma ◽  
Satoko Mizuno ◽  
Yuzo Hasegawa ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Maximum Effect ◽  
Small Cell Lung ◽  
Local Progression ◽  
Egfr Mutated ◽  
Egfr Tki

Abstract Background: Because of the invasive nature of small cell lung cancer (SCLC), the effectiveness of local therapy for brain metastases (BM) from SCLC had been limited. In this article, we retrospectively evaluated the efficacy of chemotherapy against non-treated BM from SCLC (SCLC-CHT) in compared with TKI for BM from EGFR-mutated NSCLC (EGFR-TKI).Materials and Methods: Un-treated 218 BM, including 58 SCLCs and 160 EGFR-mutated NSCLCs were enrolled. The primary endpoints were maximum response of BM and the duration of effect, and the secondary endpoints were times to the first and maximum responses, patterns of progression and overall survival after the diagnosis of BM.Results: The objective response rate (69%) and disease control rate (92%) of BM after SCLC-CHT were inferior to those after EGFR-TKI (85%, 97%), but were sufficiently satisfactory. Both the times to the first response (0.8m, 95% CI:0.6–0.9) and to the maximum effect after treatment(1.6m, 0.9–1.9) with SCLC-CHT were shorter than with EGFR-TKI (0.9m,0.9–1.0, P=0.011, and 2.4m, 1.9–2.8, P=0.004), but the duration of the response was conversely shorter with SCLC-CHT (5.1m, 4.2–5.6) than with EGFR-TKI (12.3m,9.2–15.1, P<0.0001). The dominant pattern of recurrence was local progression in the both groups. The risk of local progression after SCLC-CHT was higher than after EGFR-TKI (Fine-Gray HR:2.44, 1.56–3.83, P<0.0001), although the risk of new BM was not different between these two groups (0.94, 0.49–1.82, P=0.86). The risk of non-CNS death was higher after SCLC-CHT than after EGFR-TKI (1.8, 1.2–2.7, P=0.004), but the risk of CNS death was not different (0.92, 0.45–1.89,P=0.83).Conclusions: BM from SCLC well and quickly responded to CHT, but the duration of response was short. These responses of BM against CHT was comparable to that of extracranial disease. For the better control of BM and survival of patients, ingenuity to prolong the effect of CHT is required.

scholarly journals Afatinib in EGFR TKI-Naïve Patients with Locally Advanced or Metastatic EGFR Mutation-Positive Non-Small Cell Lung Cancer: A Pooled Analysis of Three Phase IIIb Studies

2021 ◽  
Vol 11 ◽  
Author(s):  
Antonio Passaro ◽  
Filippo de Marinis ◽  
Hai-Yan Tu ◽  
Konstantin K. Laktionov ◽  
Jifeng Feng ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Small Cell Lung ◽  
Three Phase ◽  
Phase Iiib ◽  
Ecog Ps ◽  
Egfr Tki

BackgroundAfatinib is approved for first-line treatment of patients with epidermal growth factor receptor mutation-positive (EGFRm+) non-small-cell lung cancer (NSCLC). Here, we report findings from a combined analysis of three phase IIIb studies of afatinib in EGFR tyrosine kinase inhibitor (TKI)-naïve patients.MethodsEGFR-TKI-naïve patients with EGFRm+ NSCLC received afatinib 40 mg/day. Dose reductions were permitted for adverse events (AEs). Efficacy endpoints included progression-free survival (PFS), time to symptomatic progression (TTSP), and tumor response. Subgroup analyses were performed by Eastern Cooperative Oncology Group performance status (ECOG PS), presence of brain metastasis, age and common/uncommon EGFR mutations (plus other factors).Results1108 patients were treated. Median age was 61 years (range, 25–89); 19.2% had baseline brain metastases, 4.4% had ECOG PS ≥2, and 17.9% had tumors harboring uncommon mutations. Treatment-related AEs (TRAEs) were reported in 97.2%, most commonly diarrhea and rash. 41.6% had AEs leading to dose reduction. Median PFS was 13.0 months [95% confidence interval (CI): 12.0–13.8]; median TTSP was 14.8 months (95% CI: 13.9–16.1). Objective response rate (ORR) was 55.0%. Age, presence of baseline brain metastases, major (G719X, L861Q, S768I) or compound uncommon mutations had little/no effect on PFS, TTSP, or ORR, while outcomes were poorer in patients with ECOG PS 2 or exon 20 insertion/T790M mutations.ConclusionsAfatinib was tolerable with no new safety signals. Afatinib demonstrated encouraging efficacy in a broad patient population, including those with brain metastases or uncommon EGFR mutations.

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