Metastatic Non-Small Cell Lung Cancer - DOAJ

Epidermal growth factor receptor tyrosine kinase (EGFR-TK) mutation testing in adults with locally advanced or metastatic non-small cell lung cancer: a systematic review and cost-effectiveness analysis

History: Non-small cell lung cancer is the most common form of lung cancer. Tumors are sensitive to chemotherapy with EGFR-TK inhibitors, but not so responsive to chemotherapy with standard chemotherapy, according to some epidermal growth factor receptor kinase mutations. Patients with NSCLC are then tested for EGFR-TK tumour gene mutations in order to inform treatment decisions. Object: To determine previously untreated adults with locally advanced or metastatic NSCLC who could benefit from TKI-based therapy. Data on the reliability of EGFR-TK mutation testing for predicting reaction to TKI therapy has been published in six studies. And whatever EGFR mutation test was used to select patients, there were no significant differences in the treatment effects reported by various studies. Both therascreen® EGFR polymerase chain reaction Kit and "Linked evidence" approaches were less cost-effective and less costly than direct sequencing of all exon 19-21 mutations at an incremental cost-effectiveness ratio of £32,167 and £32,190 per QALY lost, with an increasing cost-effectiveness ratio of £32,167 and £32,190 per QALY lost. Conclusion: There was no evidence that any one EGFR mutation test had more accuracy than any other measurement. TKIs and standard chemotherapy in patients with EGFR mutation-positive and mutation-negative tumors, where patient outcomes are now known, may be used to gain insight on the relative effectiveness of TKIs and standard chemotherapy in patients with EGFR mutation-positive and mutation-negative tumors, where mutation status is determined using tests for which appropriate data are currently unavailable. The National Institute for Health Research Health Technology Assessment (NIH) assessment program is funded by the National Institute for Health Research Health Technology Assessment.

Source link: https://doi.org/10.3310/hta18320

Clinical effectiveness and cost-effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic non-small cell lung cancer: a systematic review and economic evaluation

Background: The National Institute for Health and Care Excellence has published several recommendations for the first-line care of patients with lung cancer, as well as various combinations of chemotherapy regimens. Objectives: To determine the clinical safety and cost-effectiveness of first-line chemotherapy, now available in Europe and recommended by NICE for adult patients with locally advanced or metastatic non-small cell lung cancer — what aims to determine. Trial studies were conducted from 2001 to August 2010 using three electronic databases: Trial results: Trials were conducted in Europe and tested by NICE in chemotherapy-naive adult patients with locally advanced or metastatic NSCLC. Pexed + platinum in patients with non-squamous disease rises OS remarkably in statistically significant ways [hazard ratio = 0. 85; 95% confidence interval 0. 74 to 0. 98] and that docetaxel + PLAT raises OS significantly in patients with non-squamous disease, according to a statistically significant manner compared to paclitaxel + PLAT]. There were no statistically significant differences in OS among patients with EGFR M+ status in any of the comparisons. Using list prices, cisplatin doublets are preferable to carboplatin doublets, but this is reversed if electronic market information tool prices are used, in which case drug administration costs become more relevant than drug acquisition costs, which may become more relevant than drug acquisition costs. For patients with EGFR M+, the use of GEF in comparison to PAX or DOC yields provides a significant incremental cost-effectiveness ratios. The design of future lung cancer trials must reflect the influence of variables such as histology, genetics, and the latest prognostic biomarkers that are currently being developed.

Source link: https://doi.org/10.3310/hta17310

Multicenter Observational Study on Metastatic Non-Small Cell Lung Cancer Harboring BRAF Mutations: Focus on Clinical Characteristics and Treatment Outcome of V600E and Non-V600E Subgroups

Introduction: BRAF mutations account for 2–4 percent of lung adenocarcinoma. Hence, we investigated the potential prognostic significance of specific genetic variations in a real-life population of advanced-NSCLC. Advanced BRAF mutant NSCLC was investigated in this multicenter Italian retrospective study. Materials and methods: The current multicenter Italian retrospective study involved advanced BRAF mutant NSCLC. Results: A total of 44 BRAF mut NSCLC patients were included. According to V600E vs. non-V600E mutations, there were no significant differences in survival results and treatment response, but in the V600E subgroup, a trend toward prolonged PFS was observed.

Source link: https://doi.org/10.3390/cancers14082019

Randomized phase II study with two gemcitabine- and docetaxel-based combinations as first-line chemotherapy for metastatic non-small cell lung cancer

Abstract Background Docetaxel and gemcitabine regimens have been proven effective in the treatment of non-small cell lung cancer. The aim of this research was to evaluate and compare two treatment regimens, one based on our own preclinical findings and the other selected from the literature. Patients with stage IV NSCLC and at least one bidimensionally measurable lesion were both eligible. Results In arms A and B, respectively, the expected response rate was 20% and 18%. Disease control rates were very similar.

Source link: https://doi.org/10.1186/1479-5876-6-65

Epidermal growth factor receptor T790M mutation-positive metastatic non-small-cell lung cancer: focus on osimertinib (AZD9291)

The Adenocarcinoma with epidermal growth factor receptor mutations accounts for 8%–30% of all cases of NSCLC depend on geography and ethnicity. The majority of EGFR-mutated NSCLC patients respond to first-line therapy with EGFR tyrosine kinase inhibitors. Osimertinib is one of three-generation EGFR TKIs with a high specific potency against T790M mutants. The reaction rate and disease control rate were 61% and 95% respectively in Phase I of osimertinib in advanced lung cancer following progression on EGFR TKIs. In November 2015, the U. S. Food & Drug Administration approved Osimertinib for patients with T790M mutation mutations and those with progressive disease on other EGFR TKIs. With a focus on osimertinib's role in the management of EGFR mutation lung cancer and TKIs, we explore the role of EGFR TKIs in the prevention of TKIs.

Source link: https://doaj.org/article/b1e9dae6b97d4b23ad5eb04c2c186c88

Immunotherapy in non-metastatic non-small cell lung cancer: Can the benefits of stage IV therapy be translated into earlier stages?

Several strides forward in the treatment of patients with stage IV non-small cell lung cancer patients were made over the past decade. In large phase III clinical trials in stages I–III NSCLC, antigen-specific immunotherapy has been unsuccessful. Based on the latest findings in metastatic NSCLC with immune checkpoint inhibitor immunotherapy, many people with stage I–III NSCLC are currently waiting for this therapy. Here we give a brief summary of how most recent therapeutic approaches for advanced NSCLC failed in other settings, as well as a look at the role of immunotherapy in patients with stage I–III NSCLC.

Source link: https://doi.org/10.1177/1758835918772810

Therapeutic options in older patients with metastatic non-small cell lung cancer

The rise in life expectancy, as well as a rise in the risk of cancer, has resulted in an elevated risk of lung cancer in senior adults. The typical age of lung cancer diagnosis is between 63 and 70 years old. A comparison of vinorelbine and best supportive care was the first trial devoted to senior patients with advanced non-small cell lung cancer. Gemcitabine plus vinorelbine combined therapy with gemcitabine and vinorelbine gave no better results than either of these drugs alone. Hence, the treatment of elderly patients with advanced NSCLC should include monotherapy. Patients in some clinical trials not devoted to older patients may profit from platinum-based doublet therapy like their younger peers.

Source link: https://doi.org/10.1177/1758834012455838

Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Treatment of Metastatic Non-Small Cell Lung Cancer, with a Focus on Afatinib

In around half of Asian patients and in 10–15% of Caucasian patients with metastatic non-small cell lung cancer of adenocarcinoma histology, there are osteostatic epidermal growth factor receptor mutations. Patients with Del19 mutations had an improved OS in Afatinib-treated patients with improved OS. Afatinib did result in a clinical benefit in patients on first-generation EGFR-TKIs. In patients with squamous NSCLC in the second-line setting, a randomly controlled trial revealed that PFS was significantly superior with afatinib vs. erlotinib in patients with squamous NSCLC. In a first-line EGFR positive NSCLC trial comparing afatinib and gefitinib, PFS was much higher than before abolition, but OS was not significantly improved, with afatinib.

Source link: https://doi.org/10.3389/fonc.2017.00097

Overall Survival of Patients With ALK-Positive Metastatic Non–Small-Cell Lung Cancer in the Russian Federation: Nationwide Cohort Study

PURPOSE: The overall survival results in patients with ALK-positive metastatic non-cell lung cancer have rarely been reported. In patients with ALK-positive metastatic NSCLC in Russia, the aim of this prospective-retrospective cohort study was to gather real-world data on the use of crizotinib or chemotherapy in patients with ALK-positive metastatic NSCLC. PATIENTS AND METHODS: Patients with epidermal growth factor receptor receptor-negative metastatic NSCLC were tested in 23 cancer centers. Patients were expected to have confirmation of ALK rearrangement in order to be eligible. In the crizotinib group and 15. 0 months in the chemotherapy group, the average survival rate at the start of therapy was 31 months and 16. 0 months in the chemotherapy group. One complete response was received by patients with brain metastasis, while five partial responses were obtained. In three patients in the crizotinib group, three adverse events were recorded. CONCLUSION: The enhanced OS found in crizotinib clinical trials in ALK-positive NSCLC was also present in the less selective patient groups treated in daily life in Russia, as shown by the improved OS.

Source link: https://doi.org/10.1200/JGO.19.00024

In Metastatic Non-small cell Lung Cancer Platinum-Based Treated Patients, Herbal Treatment Improves the Quality of Life. A Prospective Randomized Controlled Clinical Trial

Background: Traditional Chinese Medicine herbs supplemented to platinum-based chemotherapy improve the Quality of Life in metastatic non-small cell lung cancer patients with a 0. 05 percent and power of 90 percent, according to clinical experience, but these must be prospectively validated. The only side effects attributed to some of the patients' TCM herbs were transient, mild gastric/abdominal heaviness in the first two weeks, but these also occurred among PBT+PLACEBO patients. Contrarily, the QOL variables total score, physical, and emotional subscales in PBT+PLACEBO patients with Qi-Yin deficiency and platinum-based chemotherapy were reduced after PBT-based chemotherapy, and TCM herbal medicine increases the QOL in stage IIIB-IV ECOG-PS = 0–1.

Source link: https://doi.org/10.3389/fphar.2017.00454

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