scholarly journals Evaluation of concurrent chemoradiotherapy for locally advanced NSCLC according to EGFR mutation status

2017 ◽  
Vol 14 (1) ◽  
pp. 885-890 ◽  
Author(s):  
Mikiko Ishihara ◽  
Satoshi Igawa ◽  
Jiichiro Sasaki ◽  
Sakiko Otani ◽  
Tomoya Fukui ◽  
...  
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Egfr Mutation ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Mutation Status ◽  
Locally Advanced Nsclc

A randomized, multicenter phase II study investigating additional weekly cetuximab to concurrent chemoradiotherapy in locally advanced non-small cell lung carcinoma: Reporting on the efficacy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7019-7019 ◽  
Author(s):  
Michel M van den Heuvel ◽  
Andrew D. Vincent ◽  
Wilma Uyterlinde ◽  
Joachim Aerts ◽  
Fredirike Koppe ◽  
...  
Keyword(s):  
Phase Ii ◽  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Phase Ii Study ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
High Dose ◽  
Cell Lung Carcinoma ◽  
Multicenter Phase ◽  
Locally Advanced Nsclc

7019 Background: Modest benefits from concurrent chemoradiotherapy (CRT) in patients with locally advanced NSCLC warrant more effective treatment regimen. Cetuximab, a monoclonal antibody against the epidermal growth factor receptor has shown activity in NSCLC. Feasibility data and toxicity have been published previously. We report treatment outcome of a multicenter phase II study of the combination of high dose accelerated RT and daily dose cisplatin with or without weekly cetuximab. Methods: Patients with locally advanced NSCLC received accelerated RT (66 Gy in 24 fractions) and concurrent daily cisplatin (6 mg/m2) with (Arm A) or without (Arm B) additional weekly cetuximab (400 mg/m2 loading dose one week prior to the RT start followed by weekly 250 mg/m2). The Objective Local Response Control (OLRC) was determined at 6 and 24 weeks after treatment using response evaluation criteria in solid tumours criteria. Results: Between Feb 2009 and May 2011, 102 patients were included. Median follow-up was 13 months. Patients and tumor characteristics are shows in the Table. Stage distribution was: II (8%), IIIa (51%), and IIIb (40%). The CRT was well tolerated. The OLRC at 24 weeks was 79% in Arm A and 80% in Arm B. The one-year progression free survival and overall survival were 58% (45%-76%) and 76% (64%-91%) for Arm A and 49% (35%-68%) and 72% (58%-89%) for Arm B respectively. Conclusions: The addition of cetuximab to low dose cisplation CRT does not improve OLRC in an unselected patient cohort but data on longterm disease control and survival are to be awaited. [Table: see text]

scholarly journals PO-0888: Response monitoring by 18FDG-PET in locally advanced NSCLC treated with concurrent chemoradiotherapy

2017 ◽  
Vol 123 ◽  
pp. S488 ◽  
Author(s):  
J.N.A. Van Diessen ◽  
M. La Fontaine ◽  
M. Van den Heuvel ◽  
W. Vogel ◽  
J.S.A. Belderbos ◽  
...  
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Response Monitoring ◽  
18Fdg Pet ◽  
Locally Advanced Nsclc

scholarly journals The impact of epidermal growth factor receptor mutations on patterns of disease recurrence after chemoradiotherapy for locally advanced non–small cell lung cancer: a literature review and pooled analysis

2016 ◽  
Vol 57 (5) ◽  
pp. 449-459 ◽  
Author(s):  
Satoru Ochiai ◽  
Yoshihito Nomoto ◽  
Yui Watanabe ◽  
Yasufumi Yamashita ◽  
Yutaka Toyomasu ◽  
...  
Keyword(s):  
Egfr Mutation ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Disease Recurrence ◽  
Wild Type ◽  
Mutation Status ◽  
Locally Advanced Nsclc ◽  
Significant Difference ◽  
Epidermal Growth ◽  
The Impact

Abstract The purpose of this review was to evaluate the impact of epidermal growth factor receptor (EGFR) mutation status on disease recurrence in patients treated with chemoradiotherapy (CRT) for locally advanced non–small cell lung cancer (NSCLC). A literature search was conducted and a total of three studies were analyzed. There was no significant difference in the objective response rate between the EGFR mutation group and the EGFR wild-type group (odds ratios [OR] 1.46, 95% CI, 0.79–2.70, P = 0.228), and there was no significant difference in the incidence of disease recurrence (OR 1.37, 95% CI, 0.68–2.75, P = 0.379) between the two groups. There were significant difference in the incidence of local/locoregional progression (LP) (OR 0.35, 95% CI, 0.18–0.71, P = 0.003) and distant progression (DP) (OR 2.97, 95% CI, 1.59–5.54, P < 0.001). Brain metastasis (BM) was one of the main recurrence patterns of DP, and the incidence was significantly higher in the EGFR mutant group (OR 2.75, 95% CI, 1.43–5.31, P = 0.003). There were no statistically significant heterogeneities in these pooled analyses. The patterns of recurrence after CRT for locally advanced NSCLC were different according to EGFR mutation status. LP after CRT in patients with EGFR mutation was less frequent, but the high incidence of DP, especially BM, continued to be the major problem. On the other hand, LP continued to be the major problem in EGFR wild-type patients. In multimodality treatment for inoperable locally advanced NSCLC, we may need to consider different treatment strategies according to EGFR mutation status.

Efficacy comparison of concurrent chemoradiotherapy with nedaplatin and cisplatin in inoperable locally-advanced non-small cell lung cancer

2020 ◽  
Vol 20 (5) ◽  
pp. 355-376
Author(s):  
Yongli WU ◽  
◽  
Kuantang CHEN ◽  
Jun WANG
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
High Energy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Locally Advanced Nsclc

Objective： To compare the efficacy and safety of concurrent chemoradiotherapy with nedaplatin and cisplatin in inoperative locally-advanced non-small cell lung cancer（NSCLC）.Methods： Eighty patients with locally-advanced NSCLC treated in Guanyun County People’s Hospital，Lianyungang，Jiangsu Province，from January 2015 to January 2019 were enrolled as study subjects，and were randomly divided into the nedaplatin group and the cisplatin group，each consisting of 40 patients.The patients in the 2 groups were treated with linear accelerator 6 MV high energy X-ray and 3D-CRT，5 times a week for a succession of 6 weeks，with a total dosage of 55-66 Gy.Then，the patients were given paclitaxel（155 mg/m2） intravenously for 3 hours in the first day after radiotherapy，and the patients in the cisplatin group were treated with cisplatin（80 mg/m2） intravenously for 3 to 4 days，and the patients in the nedaplatin group were given nedaplatin（80 mg/m2） intravenously also for 3 to 4 days.The efficacy，the levels of such serum tumor markers as carcinoembryonic antigen（CEA），carbohydrate antigen 125（CA125），neuron specific enolase（NSE） and cytokeratin fragment antigen 21-1（CYFRA21-1），as well as the rate of adverse drug reactions（ADRs） were compared between the 2 groups.Results： There was no statistical significance in remission rate and disease control rate，when comparisons were made between the 2 groups（P>0.05）.After treatment，CEA，CA125，NSE and CYFRA21-1 levels in the 2 groups were significantly lower than those before treatment（P<0.05）.There were no significant differences in CEA and CA125 levels，when comparisons were made between the 2 groups（P>0.05）.However，NSE and CYFRA21-1 levels in the patients of the nedaplatin group were significantly lower than those of the cisplatin group（P<0.05）.The rates of leucopenia，neutropenia，nausea and vomiting，constipation or diarrhea，increase of blood urea nitrogen or creatinine，and weight loss in the nedaplatin group were significantly lower than those in the cisplatin group（P<0.05）.Conclusion： Nedaplatin has similar efficacy as cisplatin in the treatment of inoperable locally-advanced NSCLC，with higher safety，meanwhile it could decrease the levels of NSE and CYFRA21-1.For this reason，it is worthy further clinical promotion.

scholarly journals Radiotherapy combined with gefitinib for patients with locally advanced non-small cell lung cancer who are unfit for surgery or concurrent chemoradiotherapy: A phase Ⅱ clinical trial

2020 ◽  
Author(s):  
Zhixue Fu ◽  
Jun Liang ◽  
Yang Xu ◽  
Wenqing Wang ◽  
Deng Lei ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Survival Time ◽  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Response Rate ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Locally Advanced Nsclc

Abstract Background: The objectives of this study were to determine the objective effective response rate, survival, and safety of radiotherapy combined with gefitinib in patients with locally advanced non-small cell lung cancer (NSCLC) who were unfit for surgery or concurrent chemoradiotherapy.Methods: The patients with the locally advanced NSCLC who were unfit to receive surgery or concurrent chemoradiotherapy, received thoracic intensity-modulated radiotherapy (IMRT) combined with gefitinib 250 mg daily.Results: Twenty-nine patients were enrolled between July 2014 and March 2017. Of the 29 patients, 21 (72.4%) experienced a partial response, 6 (20.7%) had stable disease, and 2 (6.9%) experienced progression of disease. The objective response rate was 72.4%, and the disease control rate was 93.1%. The median follow-up time was 51 months. The disease progression showed in 26 (89.7%) patients, including local progression in 20 (69.0%) and distant metastasis in 16 (55.2%). The median survival time (MST) and progression-free survival time (PFS) were 26 and 11 months, respectively. The 3-, 4-, 5-year survival rates were 37.6%, 29%, and 29%, respectively. The PFS rates were 17.2%, 9.2%, and 9.2%. Two patients developed grade 3 acute adverse events, and two patients developed grade 2 acute irradiation pneumonitis.Conclusions: For patients with locally advanced NSCLC who are not eligible for surgery or concurrent chemoradiotherapy, IMRT combined with gefitinib can improve the objective effective rate and is generally well-tolerated.

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