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Lung Cancer

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30 papers 25 to 100 followers
Jacopo Giuliani, Andrea Remo, Andrea Bonetti
To examine the magnitude of the clinical benefit from first-line tyrosine kinase inhibitors (TKIs) advanced non-small cell lung cancer (NSCLC) with activating epidermal growth factor receptor (EGFR)-mutations. Areas covered: The present evaluation was restricted to pivotal phase III RCTs in first-line for advanced NSCLC with activating EGFR-mutations. We have subsequently applied the European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) to the above pivotal phase III RCTs, to derive a relative ranking of the magnitude of clinically meaningful benefit...
February 2017: Expert Review of Pharmacoeconomics & Outcomes Research
Daniel S W Tan, Sue S Yom, Ming S Tsao, Harvey I Pass, Karen Kelly, Nir Peled, Rex C Yung, Ignacio I Wistuba, Yasushi Yatabe, Michael Unger, Philip C Mack, Murry W Wynes, Tetsuya Mitsudomi, Walter Weder, David Yankelevitz, Roy S Herbst, David R Gandara, David P Carbone, Paul A Bunn, Tony S K Mok, Fred R Hirsch
Mutations in the epidermal growth factor receptor gene (EGFR) represent one of the most frequent "actionable" alterations in non-small cell lung cancer (NSCLC). Typified by high response rates to targeted therapies, EGFR tyrosine kinase inhibitors (TKIs) are now established first-line treatment options and have transformed the treatment paradigm for NSCLC. With the recent breakthrough designation and approval of the third-generation EGFR TKI osimertinib, available systemic and local treatment options have expanded, requiring new clinical algorithms that take into account individual patient molecular and clinical profiles...
July 2016: Journal of Thoracic Oncology
Louis Fehrenbacher, Alexander Spira, Marcus Ballinger, Marcin Kowanetz, Johan Vansteenkiste, Julien Mazieres, Keunchil Park, David Smith, Angel Artal-Cortes, Conrad Lewanski, Fadi Braiteh, Daniel Waterkamp, Pei He, Wei Zou, Daniel S Chen, Jing Yi, Alan Sandler, Achim Rittmeyer
BACKGROUND: Outcomes are poor for patients with previously treated, advanced or metastatic non-small-cell lung cancer (NSCLC). The anti-programmed death ligand 1 (PD-L1) antibody atezolizumab is clinically active against cancer, including NSCLC, especially cancers expressing PD-L1 on tumour cells, tumour-infiltrating immune cells, or both. We assessed efficacy and safety of atezolizumab versus docetaxel in previously treated NSCLC, analysed by PD-L1 expression levels on tumour cells and tumour-infiltrating immune cells and in the intention-to-treat population...
April 30, 2016: Lancet
Minghui Zhang, Hongsheng Guo, Shu Zhao, Yan Wang, Maopeng Yang, Jiawei Yu, Yubo Yan, Yan Wang
The role of a combination of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and chemotherapy for non-small-cell lung cancer (NSCLC) has not been well established. To clarify this problem, we performed a meta-analysis with 15 studies identified from PubMed, EMBASE and the Cochrane Library. We found that the combined regimen had a significant benefit on progression-free survival (PFS) (hazard ratio (HR) = 0.80; 95% CI = 0.71-0.90; P < 0.001) and the objective response rate (ORR) (RR = 1...
June 28, 2016: Oncotarget
Minehiko Inomata, Ryuji Hayashi, Hiroaki Tanaka, Kazuki Shimokawa, Kotaro Tokui, Chihiro Taka, Seisuke Okazawa, Kenta Kambara, Tomomi Ichikawa, Toru Yamada, Toshiro Miwa, Tatsuhiko Kashii, Shoko Matsui, Kazuyuki Tobe
Treatment with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been shown to prolong survival in patients with EGFR mutation-positive non-small cell lung cancer (NSCLC). The present study performed a retrospective analysis to investigate the association between the plasma lactate dehydrogenase (LDH) levels and survival in patients with EGFR mutation-positive NSCLC receiving treatment with EGFR-TKIs. The medical charts of patients with EGFR mutation-positive NSCLC who were receiving treatment with EGFR-TKIs at Toyama University Hospital between 2007 and 2014 were assessed...
May 2016: Molecular and Clinical Oncology
Janette Greenhalgh, Kerry Dwan, Angela Boland, Victoria Bates, Fabio Vecchio, Yenal Dundar, Pooja Jain, John A Green
BACKGROUND: Epidermal growth factor receptor (EGFR) mutation positive (M+) non-small cell lung cancer (NSCLC) is emerging as an important subtype of lung cancer comprising 10% to 15% of non-squamous tumours. This subtype is more common in women than men and is less associated with smoking. OBJECTIVES: To assess the clinical effectiveness of single -agent or combination EGFR therapies used in the first-line treatment of people with locally advanced or metastatic EGFR M+ NSCLC compared with other cytotoxic chemotherapy (CTX) agents used alone or in combination, or best supportive care (BSC)...
May 25, 2016: Cochrane Database of Systematic Reviews
E-E Ke, Yi-Long Wu
First-line afatinib significantly improved progression-free survival, patient-reported outcomes, and quality of life compared with chemotherapy regimens in patients with advanced epidermal-growth-factor-receptor (EGFR) mutation-positive non-small cell lung cancer, based on results of the LUX-Lung 3 and LUX-Lung 6 trials. When the analysis of these trials was restricted to patients with common EGFR mutations only (exon 19 deletions and L858R), the advantage over chemotherapy was even more pronounced. A significant overall survival advantage was firstly demonstrated versus chemotherapy in patients with non-small cell lung cancer-harboring EGFR exon 19 deletion (del19) mutations...
June 2016: Therapeutic Advances in Respiratory Disease
GĂ©rard A Milano
The main molecular targeting of lung cancer [non-small cell lung cancer (NSCLC)] concerns mutations of epidermal growth factor receptor (EGFR). The awaited responsiveness of tumors carrying these mutations is high with for instance 60% to 80% with tyrosine kinase inhibitors hitting EGFR mutations. The EGFR T790M as a secondary mutation is responsible for the occurrence of a resistance phenomenon. A multitude of drugs have been produced and tested with the property of a specific binding at the EGFR T790M site...
December 2015: Chinese Clinical Oncology
Kyoko Otsuka, Akito Hata, Jumpei Takeshita, Chiyuki Okuda, Reiko Kaji, Katsuhiro Masago, Shiro Fujita, Nobuyuki Katakami
BACKGROUND: Efficacies of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) rechallenge have been demonstrated in EGFR-mutant non-small cell lung cancer (NSCLC). However, their efficacies were only moderate. Some preclinical studies suggested synergistic effects of bevacizumab to EGFR-TKI in TKI-resistant models. METHODS: We retrospectively evaluated clinical efficacy and safety of EGFR-TKI rechallenge with bevacizumab. Rebiopsy was performed on all studied cases to examine T790M-resistant mutation status...
October 2015: Cancer Chemotherapy and Pharmacology
Pui San Tan, Gilberto Lopes, Sanchalika Acharyya, Marcel Bilger, Benjamin Haaland
BACKGROUND: Recent trials have suggested that maintenance treatments improve outcomes for patients not progressing after first-line therapy for advanced non-small-cell lung cancer (NSCLC). However, physicians have little guidance on selecting which patients benefit the most and what drug or regimen is optimal. Here, we report a systematic review and network meta-analysis of maintenance treatments in subgroups determined by performance status (PS), epidermal growth factor receptor (EGFR) mutation, histology and response to induction...
November 2015: European Journal of Cancer
Ramsey Asmar, Naiyer A Rizvi
Lung cancers are immunogenic tumors that manage to evade the immune system by exploiting checkpoint pathways that render effector T cells anergic. Inhibition of these checkpoints can restore and invigorate endogenous antitumor T-cell responses. The immunotherapeutic approach of checkpoint inhibition has become an important treatment option for patients with advanced non-small cell lung cancer, playing a role that will continue to evolve over the coming years. The programmed death 1 inhibitors nivolumab and pembrolizumab have both been shown to induce durable responses and improve survival in a subset of patients with platinum-refractory metastatic non-small cell lung cancer...
September 2015: Cancer Journal
Jie Ting, PharmD Tien Ho, Pin Xiang, Amanda Sugay, Maher Abdel-Sattar, Leslie Wilson
OBJECTIVES: To determine the cost-effectiveness of tyrosine kinase inhibitors erlotinib or afatinib, or chemotherapy cisplatin-pemetrexed, for first-line treatment of advanced epithelial growth factor receptor mutation-positive non-small-cell lung cancer in the United States. We also assessed the expected benefit of further research to reduce uncertainty regarding which treatment is optimal. METHODS: We developed a Markov model to compare the cost-effectiveness of erlotinib, afatinib, and cisplatin-pemetrexed...
September 2015: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Lingling Du, Daniel Morgensztern
Use of platinum-based chemotherapy doublets is the standard of care for patients with advanced-stage non-small cell lung cancer, being associated with improved survival compared with best supportive care in fit patients with good performance status. Randomized studies showed that the addition of monoclonal antibodies against vascular endothelial growth factor receptor or epidermal growth factor receptor may increase the survival compared to chemotherapy alone. Patients with either advanced age or poor performance status can also benefit from chemotherapy...
September 2015: Cancer Journal
Mazen Zaarour, Chanudi Weerasinghe, Bassel Nazha, Samer Hassan, Jean-Paul Atallah
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths worldwide. At diagnosis, half of the patients are over 70 years of age, and most present with advanced disease, for which chemotherapy is recommended as first-line treatment. However, the benefit from such therapy is modest and it is at times poorly tolerated. The discovery of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) has significantly impacted the treatment of patients with EGFR mutation-positive advanced NSCLC...
2015: Expert Review of Anticancer Therapy
Zofia Piotrowska, Lecia V Sequist
Epidermal growth factor receptor (EGFR) mutations define a subset of non-small cell lung cancers that are sensitive to EGFR-targeted tyrosine kinase inhibitors (TKIs). Treatment with EGFR TKIs improves outcomes for patients whose tumors harbor these mutations, but their efficacy is limited by the development of acquired resistance. The secondary gatekeeper mutation, T790M, is the most common resistance mechanism observed in patients who progress on erlotinib and gefitinib, and a new class of drugs has recently been developed to target mutant EGFR and T790M...
September 2015: Cancer Journal
Chee-Seng Tan, David Gilligan, Simon Pacey
Discovery of activating mutations in EGFR and their use as predictive biomarkers to tailor patient therapy with EGFR tyrosine kinase inhibitors (TKIs) has revolutionised treatment of patients with advanced EGFR-mutant non-small-cell lung cancer (NSCLC). At present, first-line treatment with EGFR TKIs (gefitinib, erlotinib, and afatinib) has been approved for patients harbouring exon 19 deletions or exon 21 (Leu858Arg) substitution EGFR mutations. These agents improve response rates, time to progression, and overall survival...
September 2015: Lancet Oncology
Vishal Boolell, Muhammad Alamgeer, David N Watkins, Vinod Ganju
The landscape of advanced non-small lung cancer (NSCLC) therapies has rapidly been evolving beyond chemotherapy over the last few years. The discovery of oncogenic driver mutations has led to new ways in classifying NSCLC as well as offered novel therapeutic targets for anticancer therapy. Targets such as epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) gene rearrangements have successfully been targeted with appropriate tyrosine kinase inhibitors (TKIs). Other driver mutations such as ROS, MET, RET, BRAF have also been investigated with targeted agents with some success in the early phase clinical setting...
September 9, 2015: Cancers
Raymond U Osarogiagbon, Federico Cappuzzo, Tudor Ciuleanu, Larry Leon, Barbara Klughammer
BACKGROUND: The clinical benefit of erlotinib in treating epidermal growth factor receptor (EGFR) wildtype non-small cell lung cancer (NSCLC) has been questioned. We examined the impact of erlotinib in confirmed EGFR wildtype patients in two placebo-controlled phase III trials: the National Cancer Institute of Canada Clinical Trials Group BR.21 (BR.21) and Sequential Tarceva in Unresectable Non-Small Cell Lung Cancer (SATURN) trials. METHODS: Combined re-analysis of progression-free survival (PFS) and overall survival (OS) in patients with known wildtype EGFR, estimated by Kaplan-Meier curves and compared by two-sided log-rank test...
August 2015: Translational Lung Cancer Research
Gregory A Masters, Sarah Temin, Christopher G Azzoli, Giuseppe Giaccone, Sherman Baker, Julie R Brahmer, Peter M Ellis, Ajeet Gajra, Nancy Rackear, Joan H Schiller, Thomas J Smith, John R Strawn, David Trent, David H Johnson
PURPOSE: To provide evidence-based recommendations to update the American Society of Clinical Oncology guideline on systemic therapy for stage IV non-small-cell lung cancer (NSCLC). METHODS: An Update Committee of the American Society of Clinical Oncology NSCLC Expert Panel based recommendations on a systematic review of randomized controlled trials from January 2007 to February 2014. RESULTS: This guideline update reflects changes in evidence since the previous guideline...
October 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Jin Sheng, Yun-Peng Yang, Yuan-Yuan Zhao, Tao Qin, Zhi-Huang Hu, Ting Zhou, Ya-Xiong Zhang, Shao-Dong Hong, Yu-Xiang Ma, Hong-Yun Zhao, Yan Huang, Li Zhang
Although epidermal growth factor receptor (EGFR) monoclonal antibodies (mAbs) have been proved synergistic effect when combined with cytotoxic agents for advanced nonsmall cell lung cancer (NSCLC), the results of relevant clinical trials remain controversial. The purpose of this meta-analysis was to assess the advantage and toxicity profile of chemotherapy plus EGFR-mAbs versus chemotherapy alone for patients with NSCLC.We rigorously searched electronic databases for eligible studies reporting EGFR-mAbs combined with chemotherapy versus chemotherapy alone for patients with advanced NSCLC...
August 2015: Medicine (Baltimore)
2015-09-07 04:12:57
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