Abstract:
INTRODUCTION:Continuing tyrosine kinase inhibitor (TKI) therapy may be beneficial when patients with non-small-cell lung cancer and EGFR mutations experience gradual disease progression after initial EGFR-TKI treatment. We aimed to compare the efficacy of simultaneous EGFR-TKI and chemotherapy with that of sequential treatment after patients' disease gradually progressed after first-line EGFR-TKI treatment. PATIENTS AND METHODS:Patients with gradual progression who were EGFR-T790M mutation negative were randomly divided into two groups. In the concurrent group, patients were treated with pemetrexed plus cisplatin along with the same EGFR-TKI. In the sequential group, patients continued with EGFR-TKI until the disease progressed again, according to RECIST, then switched to chemotherapy. We evaluated the patients' progression-free survival (PFS) and overall survival times. RESULTS:Ninety-nine patients were enrolled: 49 in the concurrent group and 50 in the sequential group. The median PFS (mPFS) was 7.7 months (95% confidence interval [CI], 3.6-11.7) in the concurrent group and 5.7 months (95% CI, 3.5-7.9) in the sequential group (hazard ratio = 0.66; 95% CI, 0.44-1.00; P = .026), respectively. For the sequential group, the mPFS1 and mPFS2 were 1.8 months (95% CI, 1.4-2.3) and 3.8 months (95% CI, 3.1-4.5), respectively. The median overall survival of the concurrent group was longer than that of the sequential group (20.0 vs. 14.7 months; hazard ratio = 0.52; 95% CI, 0.32-0.85; P = .038). CONCLUSION:For patients with advanced non-small-cell lung cancer and gradual progression who are EGFR-T790M mutation negative after initial EGFR-TKI therapy, EGFR-TKI combined with chemotherapy confers longer PFS and overall survival than sequential EGFR-TKI and chemotherapy does.
journal_name
Clin Lung Cancerjournal_title
Clinical lung cancerauthors
Chang Q,Xu J,Qiang H,Teng J,Qian J,Lv M,Zhang Y,Lou Y,Zhao Y,Zhong R,Han B,Chu Tdoi
10.1016/j.cllc.2020.06.005subject
Has Abstractpub_date
2020-07-06 00:00:00eissn
1525-7304issn
1938-0690pii
S1525-7304(20)30187-Xpub_type
杂志文章abstract:INTRODUCTION:Small-cell lung cancer is an aggressive disease for which the mainstay of treatment is chemotherapy. Despite good initial responses most patients will relapse. Some will receive second-line therapy with clinical benefit, but for third-line chemotherapy there is little evidence to guide treatment decisions ...
journal_title:Clinical lung cancer
pub_type: 杂志文章,多中心研究
doi:10.1016/j.cllc.2013.11.003
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Uncertainty exists regarding the optimal surveillance imaging schedule following definitive chemoradiation (CRT) for locally advanced non-small-cell lung cancer (LA-NSCLC) with regards to both frequency and modality. We sought to document the clinical impact of frequent (at least every 4 months) surveillance ...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2016.11.010
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journal_title:Clinical lung cancer
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doi:10.1016/j.cllc.2019.06.013
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abstract::The International Lung Cancer Congress (ILCC), now in its ninth year, is a key forum for representatives of cooperative groups in North America, Europe, and Japan to discuss ongoing and planned clinical trials in lung cancer. Many of the significant strides in lung cancer treatment often originate from investigations ...
journal_title:Clinical lung cancer
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doi:10.3816/CLC.2009.n.044
更新日期:2009-09-01 00:00:00
abstract::Systemic chemotherapy results in modest improvements in survival and quality of life for patients with advanced-stage non-small-cell lung cancer (NSCLC). Administration of a platinum compound in combination with a taxane (paclitaxel or docetaxel), gemcitabine, vinorelbine, or irinotecan is considered optimal first-lin...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/clc.2005.s.014
更新日期:2005-12-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.10.010
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abstract::The ability to reliably distinguish synchronous primary non-small-cell lung cancer (NSCLC) from intrapulmonary metastatic spread affects staging and treatment decisions in resected NSCLC. Adjuvant therapy for early-stage NSCLC is complicated and recommendations are primarily based on older data from trials that used n...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.1016/j.cllc.2015.03.004
更新日期:2015-09-01 00:00:00
abstract::Randomized clinical trials (RCTs) of concurrent epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) plus chemotherapy for unselected patients with advanced non-small-cell lung cancer (NSCLC) produced negative results. Intercalated administration could avoid the reduction of chemotherapy activity du...
journal_title:Clinical lung cancer
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.cllc.2016.08.006
更新日期:2017-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.08.019
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2017.03.003
更新日期:2017-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2008.n.010
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:The optimal treatment of locally advanced non-small-cell lung cancer (NSCLC) remains controversial. We hypothesized that using a trimodality approach in selected patients with stage IIIA/IIIB disease would be both feasible and efficacious with reasonable toxicity. PATIENTS/METHODS:We enrolled 13 patients wi...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2011.06.003
更新日期:2011-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.04.001
更新日期:2014-07-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2018.12.020
更新日期:2019-05-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2014.09.010
更新日期:2015-03-01 00:00:00
abstract::Vascular endothelial growth factor (VEGF) is regulated by the hypoxia-inducible factor 1 (HIF1) pathway and is implicated in tumor progression and patient survival in many types of cancer. Insulin-like growth factor-binding protein 3 (IGFBP3) is also regulated by HIF1 but works in a completely different manner by modu...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2004.n.011
更新日期:2004-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2003.s.007
更新日期:2003-01-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.2000.s.008
更新日期:2000-12-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/clc.2005.s.002
更新日期:2005-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.1016/j.cllc.2011.06.002
更新日期:2011-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2019.06.004
更新日期:2019-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,meta分析
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.11.001
更新日期:2014-03-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2008.n.043
更新日期:2008-09-01 00:00:00
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journal_title:Clinical lung cancer
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.cllc.2016.10.009
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Malignant pleural effusion (MPE) has a profound impact on quality of life and survival in patients with lung cancer. Identification of the factors within the tumor and its environment that mediate MPE is still lacking. PATIENTS AND METHODS:Intratumoral microvessel density (MVD), endothelial cell and pericyt...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.1016/j.cllc.2013.06.007
更新日期:2013-11-01 00:00:00
abstract::Lung cancer is the leading cause of cancer deaths worldwide, with the majority of patients presenting with advanced disease. Despite the introduction of newer therapeutic agents and modest survival improvement, the overall prognosis for these patients is poor. The goals of therapy should therefore include improvement ...
journal_title:Clinical lung cancer
pub_type: 杂志文章,评审
doi:10.3816/CLC.2003.n.018
更新日期:2003-07-01 00:00:00
abstract::This study was designed as a multicenter, randomized, double-blind, placebo-controlled trial. Patients were randomized by center to placebo (16 patients, 31%), oral bexarotene 300 mg/m2/day (21 patients, 40%), or oral bexarotene 600 mg/m2/day (15 patients, 29%) following demonstration of stable or responsive disease a...
journal_title:Clinical lung cancer
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.3816/clc.2001.n.005
更新日期:2001-02-01 00:00:00
abstract::Recent developments in the chemotherapy of advanced and metastatic non small-cell lung cancer have led to significant, albeit modest, improvements in survival and quality of life. The plethora of new agents with activity in this disease has led to questions as to how these drugs can best be added to existing regimens....
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/clc.1999.n.009
更新日期:1999-11-01 00:00:00
abstract::We present a rare case of recurrent multiple lesions of bronchial epithelial-myoepithelial carcinoma in a 74-year-old man treated with local resection. Two cellular types were found: epithelial cells and myoepithelial cells. The patient remains asymptomatic at 4-years of follow-up, supporting the fact that epithelial-...
journal_title:Clinical lung cancer
pub_type: 杂志文章
doi:10.3816/CLC.2007.n.020
更新日期:2007-05-01 00:00:00