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Hendriks LE, Kerr KM, Menis J, Mok TS, Nestle U, Passaro A, Peters S, Planchard D, Smit EF, Solomon BJ, Veronesi G, Reck M. Oncogene-addicted metastatic non-small-cell lung cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2023; 34:339-357. [PMID: 36872130 DOI: 10.1016/j.annonc.2022.12.009] [Citation(s) in RCA: 129] [Impact Index Per Article: 129.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 01/24/2023] Open
Affiliation(s)
- L E Hendriks
- Department of Pulmonology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, The Netherlands
| | - K M Kerr
- Aberdeen Royal Infirmary, Aberdeen University Medical School, Aberdeen, UK
| | - J Menis
- Medical Oncology Department, University and Hospital Trust of Verona, Verona, Italy
| | - T S Mok
- Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - U Nestle
- Department of Radiation Oncology, University Hospital Freiburg, Freiburg, Germany; Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany
| | - A Passaro
- Division of Thoracic Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - S Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne University, Lausanne, Switzerland
| | - D Planchard
- Department of Medical Oncology, Thoracic Group, Gustave-Roussy Villejuif, France
| | - E F Smit
- Thoracic Oncology Service, Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Pulmonary Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - B J Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - G Veronesi
- Faculty of Medicine and Surgery-Vita-Salute San Raffaele University, Milan, Italy; Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Reck
- Department of Thoracic Oncology, Airway Research Center North, German Center for Lung Research, Lung Clinic, Grosshansdorf, Germany
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Structure-based modification of ortho-amidophenylaminopyrimidines as a novel mutant EGFR inhibitor against resistant non-small cell lung cancer. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.134499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Fukushima T, Oyamada Y, Ikemura S, Nukaga S, Inoue T, Arai D, Ohgino K, Kuroda A, Ishioka K, Sakamaki F, Suzuki Y, Terai H, Yasuda H, Kawada I, Fukunaga K, Soejima K. Real-world clinical practice for advanced non-small-cell lung cancer in the very elderly: A retrospective multicenter analysis. Clin Lung Cancer 2022; 23:532-541. [DOI: 10.1016/j.cllc.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/11/2022] [Accepted: 05/08/2022] [Indexed: 11/03/2022]
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Targeted Therapy for Older Patients with Non-Small Cell Lung Cancer: Systematic Review and Guidelines from the French Society of Geriatric Oncology (SoFOG) and the French-Language Society of Pulmonology (SPLF)/French-Language Oncology Group (GOLF). Cancers (Basel) 2022; 14:cancers14030769. [PMID: 35159036 PMCID: PMC8834005 DOI: 10.3390/cancers14030769] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/24/2022] [Accepted: 01/29/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Targeted therapy has become essential in the treatment of non-small cell lung cancer (NSCLC). There are currently no guidelines for older patients who are frailer with regard to this type of treatment. Two learned societies, the French Society of Geriatric Oncology (SoFOG) and the French-language Society of Pulmonology (SPLF)/French-language Oncology Group (GOLF), joined forces to conduct a systematic review of the literature from May 2010 to May 2021 regarding the efficacy, toxicity, and feasibility of targeted therapy in older patients with NSCLC. Guidelines were then drawn up to enable clinicians to adapt the type of targeted therapy proposed according to the oncological and geriatric profile of the older patient with NSCLC. Abstract Systematic molecular profiling and targeted therapy (TKI) have changed the face of Non-Small Cell Lung Cancer (NSCLC) treatment. However, there are no specific recommendations to address the prescription of TKI for older patients. A multidisciplinary task force from the French Society of Geriatric Oncology (SoFOG) and the French Society of Pulmonology/Oncology Group (SPLF/GOLF) conducted a systematic review from May 2010 to May 2021. Protocol registered in Prospero under number CRD42021224103. Three key questions were selected for older patients with NSCLC: (1) to whom TKI can be proposed, (2) for whom monotherapy should be favored, and (3) to whom a combination of TKI can be proposed. Among the 534 references isolated, 52 were included for the guidelines. The expert panel analysis concluded: (1) osimertinib 80 mg/day is recommended as a first-line treatment for older patients with the EGFR mutation; (2) full-dose first generation TKI, such as erlotinib or gefitinib, is feasible; (3) ALK and ROS1 rearrangement studies including older patients were too scarce to conclude on any definitive recommendations; and (4) given the actual data, TKI should be prescribed as monotherapy. Malnutrition, functional decline, and the number of comorbidities should be assessed primarily before TKI initiation.
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Biomarker Testing in Older Patients Treated for an Advanced or Metastatic Non-Squamous Non-Small-Cell Lung Cancer: The French ESME Real-Life Multicenter Cohort Experience. Cancers (Basel) 2021; 14:cancers14010092. [PMID: 35008257 PMCID: PMC8750267 DOI: 10.3390/cancers14010092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/18/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary Genomic and immunologic tumor biomarker testing has dramatically changed the prognosis of patients treated for advanced/metastatic non-squamous non-small-cell lung cancer (aNSCLC). In older patients, targeted therapy and immunotherapy appear attractive considering better tolerance and increased survival. However, it remains unclear whether they have access to biomarker testing techniques in the same proportion as younger patients. The aim of our retrospective study was to compare the proportion of biomarker testing performed in non-squamous aNSCLC at diagnosis between patients aged ≥70 years old and their younger counterparts. There was no significant difference between the two age groups in terms of frequency of biomarker testing. Among old patients tested, 22% of them presented an EGFR mutation. Biomarker testing is a crucial diagnostic tool for older patients with aNSCLC in whom the newer anti-EGFR agents have shown clear benefits. Abstract Background: Genomic and immunologic tumor biomarker testing has dramatically changed the prognosis of patients, particularly those treated for advanced/metastatic non-squamous non-small-cell lung cancer (aNSCLC) when access to targeted agents is available. It remains unclear whether older patients have access to therapy-predictive biomarker testing techniques in the same proportion as younger patients. This study aims to compare the proportion of biomarker testing performed in non-squamous aNSCLC at diagnosis between patients aged ≥70 years old and their younger counterparts. Methods: We conducted a retrospective analysis using the Epidemio-Strategy and Medical Economics (ESME) Advanced or Metastatic Lung Cancer Data Platform, a French multicenter real-life database. All patients with non-squamous aNSCLC diagnosed between 2015 and 2018 were selected. Biomarker testing corresponded to at least one molecular alteration and/or PD-L1 testing performed within 1 month before or 3 months after the aNSCLC diagnosis. Results: In total, 2848 patients aged ≥70 years and 6900 patients aged <70 years were included. Most patients were male. The proportion of current smokers at diagnosis was higher in the <70 years group (42% vs. 17%, p < 0.0001). There was no significant difference in the proportion of biomarker testing performed between the two groups (63% vs. 65%, p = 0.15). EGFR mutations were significantly more common in the older group (22% vs. 12%, p < 0.0001) and KRAS mutations significantly more frequent in the younger group (39% vs. 31% p < 0.0001). The distribution of other driver mutations (ALK, ROS1, BRAF V600E, HER2, and MET) was similar across age. In the multivariable analysis, factors independently associated with biomarker testing were gender, smoking status, history of COPD, stage at primary diagnosis, and histological type. Conclusions: Age is not a barrier to biomarker testing in patients with aNSCLC.
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First-line osimertinib in elderly patients with epidermal growth factor receptor-mutated advanced non-small cell lung cancer: a retrospective multicenter study (HOT2002). Sci Rep 2021; 11:23140. [PMID: 34848786 PMCID: PMC8632978 DOI: 10.1038/s41598-021-02561-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/18/2021] [Indexed: 01/04/2023] Open
Abstract
Osimertinib is a standard of care therapy for previously untreated epidermal growth factor receptor mutation-positive non-small cell lung cancer. However, limited data exist regarding the efficacy and safety of osimertinib as a first-line therapy for elderly patients aged 75 years or older. To assess the potential clinical benefits of osimertinib in this population, this retrospective multi-institutional observational study included 132 patients with non-small cell lung cancer (age ≥ 75 years), who received osimertinib as first-line treatment. The proportion of patients with 1-year progression-free survival was 65.8% (95% confidence interval 57.1–73.5). The median progression-free survival was 19.4 (95% confidence interval 15.9–23.9) months. The median overall survival was not reached (95% confidence interval 24.6–not reached). The frequency of pneumonitis was 17.4%, with a grade 3 or higher rate of 9.1%. More than two-thirds of treatment discontinuations due to pneumonitis occurred within 3 months of starting osimertinib, and the prognosis of patients with pneumonitis was unsatisfactory. Osimertinib is one of the effective first-line therapeutic options for patients aged 75 years or older; however, special caution should be exercised due to the potential development of pneumonitis.
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Losanno T, Gridelli C. First-Line Treatment of Metastatic Non-Small Cell Lung Cancer in the Elderly. Curr Oncol Rep 2021; 23:119. [PMID: 34342732 DOI: 10.1007/s11912-021-01105-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Treatment of elderly patients with non-small-cell lung cancer (NSCLC) represents still a challenge for higher risk of comorbidity, deteriorations in physical, organ, and cognitive functions, a potentially different pharmacokinetics, diminished social support, and immunosenescense. Here, we aim to report and analyse the most relevant and recent literature defining the role of chemotherapy, targeted therapy, and immunotherapy in the first-line treatment of elderly patients with metastatic NSCLC. RECENT FINDINGS In the past years, treatment of NSCLC was based on cytotoxic chemotherapy, but recently, new drugs are deeply changing therapeutic standards, such as targeted therapy for oncogene addicted NSCLC, and immunotherapy. Despite lung cancer is primarily a disease of the elderly, they are under-represented in clinical trials. Targeted therapies and immune checkpoint inhibitors are largely considered to be appropriated for elderly too, because of their manageability, and fewer side effects compared with cytotoxic chemotherapy. However, we need further investigations to define and to choose the better treatment option for each elderly patient.
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Affiliation(s)
- Tania Losanno
- Division of Medical Oncology, "S. Ottone Frangipane" Hospital, Ariano Irpino, Italy
| | - Cesare Gridelli
- Division of Medical Oncology, "S.G. Moscati" Hospital, Città Ospedaliera, 8,Contrada Amoretta, 83100, Avellino, Italy.
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Shaikh M, Shinde Y, Pawara R, Noolvi M, Surana S, Ahmad I, Patel H. Emerging Approaches to Overcome Acquired Drug Resistance Obstacles to Osimertinib in Non-Small-Cell Lung Cancer. J Med Chem 2021; 65:1008-1046. [PMID: 34323489 DOI: 10.1021/acs.jmedchem.1c00876] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The pyrimidine core-containing compound Osimertinib is the only epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) from the third generation that has been approved by the U.S. Food and Drug Administration to target threonine 790 methionine (T790M) resistance while sparing the wild-type epidermal growth factor receptor (WT EGFR). It is nearly 200-fold more selective toward the mutant EGFR as compared to the WT EGFR. A tertiary cystein 797 to serine 797 (C797S) mutation in the EGFR kinase domain has hampered Osimertinib treatment in patients with advanced EGFR-mutated non-small-cell lung cancer (NSCLC). This C797S mutation is presumed to induce a tertiary-acquired resistance to all current reversible and irreversible EGFR TKIs. This review summarizes the molecular mechanisms of resistance to Osimertinib as well as different strategies for overcoming the EGFR-dependent and EGFR-independent mechanisms of resistance, new challenges, and a future direction.
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Affiliation(s)
- Matin Shaikh
- H. R. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
| | - Yashodeep Shinde
- R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
| | - Rahul Pawara
- R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
| | - Malleshappa Noolvi
- Shree Dhanvantari College of Pharmacy, Kim, Surat, Gujarat, India 394111
| | - Sanjay Surana
- R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
| | - Iqrar Ahmad
- R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
| | - Harun Patel
- R. C. Patel Institute of Pharmaceutical Education and Research, Shirpur, Maharashtra, India 425405
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Sumi T, Kamada K, Shijubou N, Yamada Y, Nakata H, Mori Y, Chiba H. Long-term response to osimertinib in elderly patients with lung adenocarcinoma harbouring de novo EGFR T790M: a case report and literature review. Respirol Case Rep 2021; 9:e00759. [PMID: 33976888 PMCID: PMC8094050 DOI: 10.1002/rcr2.759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 11/16/2022] Open
Abstract
Osimertinib is a potent and irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) that selectively acts on both EGFR-sensitive and EGFR T790M-resistant mutations. Patients with pre-treatment EGFR T790M mutations (de novo EGFR T790M) respond poorly to existing EGFR-TKIs, whereas osimertinib has positive effects. However, the safety data for first-line osimertinib treatment in patients aged >75 years are insufficient. We treated two elderly patients with de novo EGFR T790M mutations with osimertinib as the first-line therapy. We found that the first-line treatment with osimertinib was safe and resulted in a long-term response in elderly patients with de novo EGFR T790M-mutated lung adenocarcinoma.
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Affiliation(s)
- Toshiyuki Sumi
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
- Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
| | - Koki Kamada
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
- Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
| | - Naoki Shijubou
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
- Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
| | - Yuichi Yamada
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
| | - Hisashi Nakata
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
| | - Yuji Mori
- Department of Pulmonary MedicineHakodate Goryoukaku HospitalHakodateJapan
| | - Hirofumi Chiba
- Department of Respiratory Medicine and AllergologySapporo Medical University School of MedicineSapporoJapan
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O'Leary C, McSorley L, Hennessy B, Grogan L, Breathnach O, Morris P. Challenges associated with systemic therapy for older patients with inoperable non-small cell lung cancer. Expert Opin Pharmacother 2020; 21:2185-2194. [PMID: 32866411 DOI: 10.1080/14656566.2020.1801639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Lung cancer is the most common cancer diagnosed worldwide. Data from several studies fall short to make appropriate conclusions on the management for elderly patients. The discovery of targeted therapy and immunotherapy has allowed these patients access to a wider array of options. AREAS COVERED The authors review research for treating older patients with lung cancer focusing on research performed in this patient population. Data are presented relating to chemotherapy, immunotherapy, and targeted therapy in the advanced setting. EXPERT OPINION Elderly patients particularly benefit from advances in systemic therapy. Based on the tumor profile, treatment with targeted therapy or immunotherapy should be favored over chemotherapy where possible in the elderly population. Elderly patients benefit from EGFR, ALK, and ROS-1 inhibition in the setting of these tumor alterations. These agents should be utilized early in the treatment course. Across many studies, the benefit from immunotherapy is seen irrespective of age. Favorable outcomes and toxicity profiles from immunotherapy compared to chemotherapy are well described. Chemotherapy should be offered with caution after a detailed assessment. Options include combination or single-agent chemotherapy regimens. Best supportive care alone is a reasonable option in the frailer, highly co-morbid patient.
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Affiliation(s)
- Connor O'Leary
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
| | - Lynda McSorley
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
| | - Bryan Hennessy
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
| | - Liam Grogan
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
| | - Oscar Breathnach
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
| | - Patrick Morris
- Department of Medical Oncology, Beaumont Hospital , Beaumont, Ireland
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Liu J, Li X, Shao Y, Guo X, He J. The efficacy and safety of osimertinib in treating nonsmall cell lung cancer: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21826. [PMID: 32846826 PMCID: PMC7447427 DOI: 10.1097/md.0000000000021826] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is the primary treatment in treating with EGFR mutant nonsmall cell lung cancer (NSCLC). This systematic review and meta-analysis aimed to evaluate the efficacy and safety of the third-generation EGFR-TKI, osimertinib, and summarize the risk factors associating with outcome after osimertinib treatment. METHOD The Ovid Medline, Embase, Cochrane Library, and Pubmed were systematically searched due to December 10, 2019. All the studies that mentioned the overall survival (OS), progression-free survival (PFS), treatment response, and adverse events (AEs) of osimertinib were involved in our study. Hazard ratio (HR) with 95% confidence intervals was used for comparing OS and PFS. RESULT A total of 47 studies were included in the systematic review, of which 14 studies were used to compare the efficacy between osimertinib and other EGFR-TKI or chemotherapy. Patients treating with osimertinib favors a higher OS and PFS in all the patients (HR = 0.56 and 0.38, P < .001, respectively), and in subgroup analysis, compared with other treatments. Median 55% T790 mutant NSCLC patients might experience partial response, and 25% of patients remained as stable disease. The incidence of severe AE ranged from 0% to 5%, and the most common severe AE was pneumonia (3%). Patients with the T858R mutation may have a better OS than Del 19 mutation (HR = 0.55, P = .037), while patients who have a smoking history may have a higher risk of progression than never-smoker patients (HR = 1.47, P = .028). CONCLUSION Osimertinib has an impressive antitumor activity compared with prior EGFR-TKI and chemotherapy with an acceptable response and tolerable AEs. EGFR mutation type and smoking status were the risk factors for mortality and progression in NSCLC patients.
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Nakao A, Hiranuma O, Uchino J, Sakaguchi C, Araya T, Hiraoka N, Ishizuka T, Takeda T, Kawasaki M, Goto Y, Imai H, Hattori N, Nakatomi K, Uramoto H, Uryu K, Fukuda M, Uchida Y, Yokoyama T, Akai M, Mio T, Nagashima S, Chihara Y, Tamiya N, Kaneko Y, Mouri T, Yamada T, Yoshimura K, Fujita M, Takayama K. Final Results from a Phase II Trial of Osimertinib for Elderly Patients with Epidermal Growth Factor Receptor t790m-Positive Non-Small Cell Lung Cancer That Progressed during Previous Treatment. J Clin Med 2020; 9:E1762. [PMID: 32517152 PMCID: PMC7356339 DOI: 10.3390/jcm9061762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022] Open
Abstract
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are used for treating EGFR-mutated lung cancer, and osimertinib is effective in cases that acquired T790M mutations after treatment with the first- and second-generation EGFR-TKIs. However, no study has evaluated its safety and efficacy in older patients. This phase II trial (jRCTs071180002) evaluated osimertinib in T790M mutation-positive Japanese patients who were ≥75 years old and had experienced relapse or progression after previous EGFR-TKI treatment. Our previous report that enrolled 36 patients showed the overall response rate (58.3%) and disease control rate (97.2%), while this report describes the results for the progression-free survival (PFS), overall survival (OS), and safety analyses. The median PFS was 11.9 months (95% confidence interval (CI): 7.9-17.5), and the median OS was 22.0 months (95% CI: 16.0 months-not reached). The most frequent adverse events were anemia/hypoalbuminemia (27 patients, 75.0%), thrombocytopenia (21 patients, 58.3%), and paronychia/anorexia/diarrhea/neutropenia (15 patients, 41.7%). Pneumonitis was observed in four patients (11.1%), including two patients (5.6%) with Grade 3-4 pneumonitis. These results suggest that osimertinib was relatively safe and effective for non-small cell lung cancer that acquired T790M mutations after previous EGFR-TKI treatment, even among patients who were ≥75 years old.
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Affiliation(s)
- Akira Nakao
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (A.N.); (M.F.)
| | - Osamu Hiranuma
- Department of Respiratory Medicine, Otsu City Hospital, Shiga 520-0804, Japan;
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Chikara Sakaguchi
- Department of Pulmonary Medicine, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan;
| | - Tomoyuki Araya
- Department of Respiratory Medicine, National Hospital Organization, Kanazawa Medical Center, Ishikawa 920-8650, Japan;
| | - Noriya Hiraoka
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan;
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan;
| | - Takayuki Takeda
- Department of Respiratory Medicine, Japanese Red Cross Society Kyoto Daini Hospital, Kyoto 602-8026, Japan;
| | - Masayuki Kawasaki
- Department of Respiratory Medicine, National Hospital Organization, Omuta National Hospital, Fukuoka 837-0911, Japan;
| | - Yasuhiro Goto
- Department of Respiratory Medicine, Fujita Health University, Aichi 470-1192, Japan;
| | - Hisao Imai
- Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Gunma 373-8550, Japan;
| | - Noboru Hattori
- Department of Molecular and Internal Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Keita Nakatomi
- Department of Respiratory Medicine, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka 815-8588, Japan;
| | - Hidetaka Uramoto
- Department of Thoracic Surgery, Kanazawa Medical University, Ishikawa 920-0293, Japan;
| | - Kiyoaki Uryu
- Department of Respiratory Medicine, Yao Tokushukai General Hospital, Osaka 581-0011, Japan;
| | - Minoru Fukuda
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki 852-8523, Japan;
| | - Yasuki Uchida
- Department of Respiratory Medicine, Shiga University of Medical Science Hospital, Shiga 520-2192, Japan;
| | - Toshihide Yokoyama
- Department of Respiratory Medicine, Kurashiki Central Hospital, Okayama 710-8602, Japan;
| | - Masaya Akai
- Department of Respiratory Medicine, Japanese Red Cross Fukui Hospital, Fukui 918-8501, Japan;
| | - Tadashi Mio
- Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan;
| | - Seiji Nagashima
- Department of Respiratory Medicine, National Hospital Organization Nagasaki Medical Center, Nagasaki 856-0835, Japan;
| | - Yusuke Chihara
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Nobuyo Tamiya
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Yoshiko Kaneko
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Takako Mouri
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
| | - Kenichi Yoshimura
- Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Masaki Fujita
- Department of Respiratory Medicine, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan; (A.N.); (M.F.)
| | - Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (Y.C.); (N.T.); (Y.K.); (T.M.); (T.Y.); (K.T.)
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Ebi H, Boikos S, Faber AC. Respecting your elders: osimertinib demonstrates preferential activity in elderly patients with T790M positive non-small cell lung cancers. J Thorac Dis 2019; 11:S1844-S1846. [PMID: 31632765 DOI: 10.21037/jtd.2019.08.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiromichi Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya, Japan.,Precision Medicine Center, Aichi Cancer Center, Nagoya, Japan.,Division of Advanced Cancer Therapeutics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Anthony C Faber
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, VA, USA
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Lamberti G, Andrini E, Ricciuti B. Impact of performance status and age on osimertinib efficacy in patients with EGFR-mutant T790M-positive non-small-cell lung cancer. J Thorac Dis 2019; 11:S1831-S1834. [PMID: 31632761 PMCID: PMC6783754 DOI: 10.21037/jtd.2019.08.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 08/21/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Giuseppe Lamberti
- Department of Specialized, Experimental and Diagnostic Medicine, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Elisa Andrini
- Department of Specialized, Experimental and Diagnostic Medicine, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Biagio Ricciuti
- Thoracic Oncology Unit, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Menghini, Perugia, Italy
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