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Chang H, Huang K, Tseng C, Chen Y, Lai C, Chang Y, Chen Y, Chuang H, Wang C. Survival outcomes of east Asian patients with advanced non-small cell lung cancer treated with first-line EGFR tyrosine kinase inhibitors: A network meta-analysis of real-world evidence. Thorac Cancer 2023; 14:3217-3225. [PMID: 37704454 PMCID: PMC10643793 DOI: 10.1111/1759-7714.15112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND The comparative efficacies of different generation tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC) remain largely unknown. Moreover, whether one EGFR-TKI confers superior survival remains unclear, especially in East Asians. We conducted a network meta-analysis (NMA) comparing the survival outcomes of East Asian patients with advanced NSCLC treated with first-line EGFR-TKIs. METHODS The NMA included observational real-world evidence studies on adult patients with EGFR-mutated advanced NSCLC who received first (gefitinib and erlotinib), second (afatinib), or third (osimertinib) generation EGFR-TKIs as frontline therapy. Studies were identified through an online bibliographic search of Medline articles in the PubMed, SCOPUS, Web of Science, and Cochrane Library databases. RESULTS For overall survival (OS), afatinib had significantly better hazard ratios (HRs) than osimertinib (HR: 0.46, 95% confidence interval [CI]: 0.23-0.91), gefitinib (HR: 0.56, 95% CI: 0.43-0.72), and erlotinib (HR: 0.71, 95% CI: 0.54-0.92). For progression-free survival (PFS), afatinib had significantly better HRs than gefitinib (HR: 0.45, 95% CI: 0.36-0.56) and erlotinib (HR: 0.63, 95% CI: 0.49-0.81). Moreover, afatinib was most likely to achieve the longest OS (81.3%), followed by erlotinib (13%), osimertinib, and gefitinib. Furthermore, afatinib was most likely to achieve the longest PFS (48.3%), followed by osimertinib (34.9%) and erlotinib. CONCLUSIONS This real-world evidence shows that afatinib confers better survival than other first-line EGFR-TKIs in East Asian patients with advanced NSCLC.
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Affiliation(s)
- Huang‐Chih Chang
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiung CityTaiwan
| | - Kuo‐Tung Huang
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chia‐Cheng Tseng
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Yu‐Mu Chen
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Chien‐Hao Lai
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Yu‐Ping Chang
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
| | - Yung‐Che Chen
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
- Department of Respiratory TherapyKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiungTaiwan
| | - Hung‐Yi Chuang
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, and Research Center for Precision Environmental MedicineKaohsiung Medical UniversityKaohsiung CityTaiwan
- Department of Occupational and Environmental MedicineKaohsiung Medical University HospitalKaohsiung CityTaiwan
| | - Chin‐Chou Wang
- Divisions of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineKaohsiungTaiwan
- Department of Respiratory TherapyKaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiungTaiwan
- Department of Respiratory CareChang Gung University of Science and TechnologyChiayiTaiwan
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Kuo CHS, Su PL, Wei YF, Ko JC, Tseng JS, Su J, Chiang CL, Chen CY, Lin CC, Wang CC, Ho CC, Chang HC, Hung JY. T790M detection rate after first-line combination therapy with bevacizumab and EGFR-TKIs in advanced NSCLC (TERRA Study). Am J Cancer Res 2023; 13:3100-3112. [PMID: 37559987 PMCID: PMC10408489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/14/2023] [Indexed: 08/11/2023] Open
Abstract
Real-world data regarding the T790M mutation rate after acquiring resistance to first-line combination therapy with epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and bevacizumab in patients with advanced non-small-cell lung cancer (NSCLC) are limited. The present study was aimed at analyzing predictors of acquired T790M mutations in this patient group. A total of 107 patients who received first-line combination therapy with EGFR-TKIs and bevacizumab at 11 tertiary referral centers in Taiwan were enrolled in this multicenter retrospective study. Survival data and genomic test results after acquiring resistance were analyzed. We discovered that patients who received a combination of afatinib, a second generation EGFR-TKI, and bevacizumab showed better progression-free survival (PFS). After disease progression, 59 patients (55.1%) were confirmed to test positive for EGFR T790M. A longer duration of first-line therapy could be a predictor of subsequent T790M mutations. To our knowledge, this is one of the few and early studies to demonstrate the T790M mutation rate after first-line combination therapy with an EGFR-TKI and bevacizumab. Whether the longer PFS afforded by the addition of bevacizumab could lead to subsequent T790M mutations needs further investigation.
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Affiliation(s)
- Chih-Hsi Scott Kuo
- Division of Thoracic Oncology, Department of Thoracic Medicine, Linkou Chang Gung Memorial HospitalTaoyuan 333, Taiwan
- Chang Gung University College of MedicineTaoyuan 333, Taiwan
| | - Po-Lan Su
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan 701, Taiwan
| | - Yu-Feng Wei
- Department of Internal Medicine, E-Da Cancer Hospital, I-Shou UniversityKaohsiung 807, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou UniversityKaohsiung 807, Taiwan
| | - Jen-Chung Ko
- Department of Internal Medicine, National Taiwan University Hospital, Hsin-Chu BranchHsinchu 300, Taiwan
| | - Jeng-Sen Tseng
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing UniversityTaichung 402, Taiwan
- Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General HospitalTaichung 407, Taiwan
- Institute of Biomedical Sciences, National Chung Hsing UniversityTaichung 402, Taiwan
- College of Medicine, National Yang Ming Chiao Tung UniversityTaipei 112, Taiwan
| | - Jian Su
- Chest Division, Department of Internal Medicine, MacKay Memorial HospitalTaipei 100, Taiwan
| | - Chi-Lu Chiang
- Division of Thoracic Oncology, Department of Chest Medicine, Taipei Veterans General HospitalTaipei 112, Taiwan
| | - Chung-Yu Chen
- Department of Internal Medicine, National Taiwan University Hospital Yunlin BranchYunlin 640, Taiwan
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan UniversityTaipei 100, Taiwan
| | - Chien-Chung Lin
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan 701, Taiwan
- Institute of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung UniversityTainan 701, Taiwan
- Department of Biochemistry and Molecular Biology, College of Medicine, National Cheng Kung UniversityTainan 701, Taiwan
| | - Chin-Chou Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiung 807, Taiwan
- Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiung 807, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and TechnologyChiayi 600, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University HospitalTaipei 100, Taiwan
- College of Medicine, National Taiwan UniversityTaipei 100, Taiwan
| | - Huang-Chih Chang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiung 807, Taiwan
| | - Jen-Yu Hung
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical UniversityKaohsiung 807, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical UniversityKaohsiung 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical UniversityKaohsiung 807, Taiwan
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Wang T, Leu Y, Chen C, Li H, Yang S, Huang K, Chen C. Psorachromene induces apoptosis and suppresses tumor growth in
NSCLC
cells harboring
EGFR L858R
/
T790M
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C797S. Phytother Res 2022; 36:2116-2126. [DOI: 10.1002/ptr.7432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Tong‐Hong Wang
- Graduate Institute of Health Industry Technology and Research Center for Chinese Herbal Medicine, College of Human Ecology Chang Gung University of Science and Technology Taoyuan Taiwan
- Tissue Bank Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan
| | - Yann‐Lii Leu
- Tissue Bank Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan
- Graduate Institute of Natural Products Chang Gung University Taoyuan Taiwan
| | - Chin‐Chuan Chen
- Tissue Bank Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan
- Graduate Institute of Natural Products Chang Gung University Taoyuan Taiwan
| | - Hsin‐Jung Li
- Institute of Cellular and Organismic Biology Academia Sinica Taipei Taiwan
| | | | - Kuo‐Yen Huang
- Department and Graduate Institute of Microbiology and Immunology National Defense Medical Center Taipei Taiwan
- National Taiwan University YongLin Institute of Health National Taiwan University Taipei Taiwan
| | - Chi‐Yuan Chen
- Graduate Institute of Health Industry Technology and Research Center for Chinese Herbal Medicine, College of Human Ecology Chang Gung University of Science and Technology Taoyuan Taiwan
- Tissue Bank Chang Gung Memorial Hospital at Linkou Taoyuan Taiwan
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Yong J, Huang L, Chen G, Luo X, Chen H, Wang L. High expression of Stabilin-2 predicts poor prognosis in non-small-cell lung cancer. Bioengineered 2021; 12:3426-3433. [PMID: 34227915 PMCID: PMC8806826 DOI: 10.1080/21655979.2021.1943109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Stabilin-2 has been found to regulate the progression of cancer. It was not fully understood whether it shows some roles in non-small-cell lung cancer (NSCLC). We used the immunohistochemical staining to evaluate Stabilin-2 protein expression in formalin-fixed paraffin-embedded tissue of NSCLC patients’ primary lesion. And we carried out χ2 test to detect relationships between Stabilin-2 expression and various clinical factors. Besides, the survival difference between patients with high and low Stabilin-2 expression was also analyzed. The expression of Stabilin-2 was associated with N stage and age. Higher Stabilin-2 expression exists in poorer survival patients. It revealed that Stabilin-2 expression was a significant predictor for both OS and DFS by univariate and multivariate analyses. High stabilin-2 expression in NSCLC predicts poor tumor prognosis.
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Affiliation(s)
- Juanjuan Yong
- Pathology Dept. Of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Liyun Huang
- Pathology Dept. Of Sun Yat-sen University Cancer Center of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Gengbiao Chen
- Pathology Dept. Of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiaoya Luo
- Pathology Dept. Of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Hui Chen
- Obstetrics and Gynecology Dept. Of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Lin Wang
- Pathology Dept. Of Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, China
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