- Lung and Thoracic cancer
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EGFR-TKI Combined with Pemetrexed versus EGFR-TKI Monotherapy in Advanced EGFR-Mutated NSCLC: A Prospective, Randomized, Exploratory Study
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Weiguang Gu, Hua Zhang, Yiyu Lu, Minjing Li, Shuang Yang, Jianmiao Liang, Zhijian Ye, Zhihua Li, Minhong He, Xiaoliang Shi, Fei Wang, Dong You, Weiquan Gu, Weineng Feng
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Cancer Res Treat. 2023;55(3):841-850. Published online February 13, 2023
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DOI: https://doi.org/10.4143/crt.2022.1438
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 Abstract
 PDF Supplementary Material PubReader ePub
- Purpose
We aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)–mutated patients with or without concomitant alterations.
Materials and Methods
This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non–small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR–tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint.
Results
The overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment.
Conclusion
EGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.
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Citations
Citations to this article as recorded by  - SP3-induced Timeless transcription contributes to cell growth of lung adenocarcinoma cells
Ping Tian, Dajun Du, Li Yang, Nan Zhou, Ling Tao, Divijendra Natha Reddy Sirigiri
PLOS ONE.2024; 19(2): e0298295. CrossRef - PIK3CA mutation as an acquired resistance driver to EGFR-TKIs in non-small cell lung cancer: Clinical challenges and opportunities
Xiaohong Liu, Wuxuan Mei, Pengfei Zhang, Changchun Zeng
Pharmacological Research.2024; 202: 107123. CrossRef - Risk factors for interstitial lung disease in patients with non-small cell lung cancer with epidermal growth factor receptor-tyrosine kinase inhibitors: A systematic review and meta-analysis
Yosuke Fukuda, Yoshitaka Uchida, Koichi Ando, Ryo Manabe, Akihiko Tanaka, Hironori Sagara
Respiratory Investigation.2024; 62(3): 481. CrossRef - Concomitant genomic features stratify prognosis to patients with advanced EGFR mutant lung cancer
Xiao Liang, Jiali Xu, Yuqin Jiang, Yuqian Yan, Hongshuai Wu, Jiali Dai, Yanan Cui, Chen Zhang, Wei Chen, Zhihong Zhang, Renhua Guo
Molecular Carcinogenesis.2024; 63(9): 1643. CrossRef - Identification and Application of Emerging Biomarkers in Treatment of Non-Small-Cell Lung Cancer: Systematic Review
Juan Carlos Restrepo, Darly Martínez Guevara, Andrés Pareja López, John Fernando Montenegro Palacios, Yamil Liscano
Cancers.2024; 16(13): 2338. CrossRef
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The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Pathological Response for Resectable Non–Small Cell Lung Cancer Treated with Neoadjuvant Chemotherapy Combined with PD-1 Checkpoint Inhibitors
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Xiaoyan Sun, Yingnan Feng, Bin Zhang, Wuhao Huang, Xiaoliang Zhao, Hua Zhang, Dongsheng Yue, Changli Wang
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Cancer Res Treat. 2022;54(4):1017-1029. Published online November 23, 2021
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DOI: https://doi.org/10.4143/crt.2021.1007
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Abstract
PDFPubReaderePub
- Purpose
The aim of our study was to investigate the value of baseline and preoperative neutrophil-to-lymphocyte ratio (NLR) in predicting the pathological response and disease-free survival (DFS) of neoadjuvant chemotherapy alone or combined with programmed cell death-1 (PD-1) checkpoint inhibitors in patients with resectable non‒small cell lung cancer (NSCLC).
Materials and Methods
Resectable NSCLC patients who underwent neoadjuvant chemotherapy alone or combined with PD-1 checkpoint inhibitors between January 2018 and January 2020 were included. Peripheral venous blood samples of the patients were collected within 3 days prior to the first neoadjuvant treatment and within 3 days prior to surgery.
Results
A total of 79 patients in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group and 89 patients in neoadjuvant chemotherapy alone group were included. Thirty-five point four percent of the patients achieved pathological complete response (pCR) in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group, whereas only 9.0% reached pCR in the group of neoadjuvant chemotherapy. High NLR level were correlated with poor pathological response and DFS in neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors group. Multivariate analysis revealed that baseline NLR could independently predict pathological response and DFS in the neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group.
Conclusion
High NLR level were correlated with poor pathological response and shorter DFS in patients with NSCLC undergoing neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors. Meanwhile, baseline NLR could independently predict response to pathological response and DFS, revealing its potential as a screening tool in NSCLC patients who received neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors.
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Citations
Citations to this article as recorded by - Circulating biomarkers as predictors of response to immune checkpoint inhibitors in NSCLC: Are we on the right path?
Calogera Claudia Spagnolo, Francesco Pepe, Giuliana Ciappina, Francesco Nucera, Paolo Ruggeri, Andrea Squeri, Desirèe Speranza, Nicola Silvestris, Umberto Malapelle, Mariacarmela Santarpia
Critical Reviews in Oncology/Hematology.2024; 197: 104332. CrossRef - Easily applicable predictive score for MPR based on parameters before neoadjuvant chemoimmunotherapy in operable NSCLC: a single-center, ambispective, observational study
Mingming Hu, Xiaomi Li, Haifeng Lin, Baohua Lu, Qunhui Wang, Li Tong, Hongxia Li, Nanying Che, Shaojun Hung, Yi Han, Kang Shi, Chenghai Li, Hongmei Zhang, Zhidong Liu, Tongmei Zhang
International Journal of Surgery.2024; 110(4): 2275. CrossRef - Dynamics of peripheral blood inflammatory index predict tumor pathological response and survival among patients with locally advanced non-small cell lung cancer who underwent neoadjuvant immunochemotherapy: a multi-cohort retrospective study
Wenyu Zhai, Chao Zhang, Fangfang Duan, Jingdun Xie, Shuqin Dai, Yaobin Lin, Qihang Yan, Bingyu Rao, Liang Li, Yuheng Zhou, Zerui Zhao, Hao Long, Junye Wang
Frontiers in Immunology.2024;[Epub] CrossRef - Predicting Pathologic Complete Response in Locally Advanced Rectal Cancer with [68Ga]Ga-FAPI-04 PET, [18F]FDG PET, and Contrast-Enhanced MRI: Lesion-to-Lesion Comparison with Pathology
Xiao Zhang, Zhenyu Lin, Yuan Feng, Zhaoguo Lin, Kaixiong Tao, Tao Zhang, Xiaoli Lan
Journal of Nuclear Medicine.2024; 65(10): 1548. CrossRef - Radiomics nomogram combined with clinical factors for predicting pathological complete response in resectable esophageal squamous cell carcinoma
Zihao Lu, Yongsen Li, Wenxuan Hu, Yonghao Cao, Xin Lv, Xinyu Jia, Shiyu Shen, Jun Zhao, Chun Xu
Frontiers in Oncology.2024;[Epub] CrossRef - Mean platelet volume/platelet count ratio in combination with tumor markers in colorectal cancer: a retrospective clinical study
Huan Zhang, Fan Lin, Zhuocai Wang
BMC Cancer.2023;[Epub] CrossRef - Development and validation of a radiomics-based nomogram for predicting a major pathological response to neoadjuvant immunochemotherapy for patients with potentially resectable non-small cell lung cancer
Chaoyuan Liu, Wei Zhao, Junpeng Xie, Huashan Lin, Xingsheng Hu, Chang Li, Youlan Shang, Yapeng Wang, Yingjia Jiang, Mengge Ding, Muyun Peng, Tian Xu, Ao’ran Hu, Yuda Huang, Yuan Gao, Xianling Liu, Jun Liu, Fang Ma
Frontiers in Immunology.2023;[Epub] CrossRef - Prognostic role of preoperative inflammatory markers in postoperative patients with colorectal cancer
Zilong Xiao, Xinxin Wang, Xiaoxiao Chen, Jiawei Zhou, Haitao Zhu, Jiangnan Zhang, Wensheng Deng
Frontiers in Oncology.2023;[Epub] CrossRef - Pan-Immune-Inflammatory Value in Patients with Non-Small-Cell Lung Cancer Undergoing Neoadjuvant Immunochemotherapy
Wen-Yu Zhai, Fang-Fang Duan, Yao-Bin Lin, Yong-Bin Lin, Ze-Rui Zhao, Jun-Ye Wang, Bing-Yu Rao, Lie Zheng, Hao Long
Journal of Inflammation Research.2023; Volume 16: 3329. CrossRef - The predictive value of 18F-FDG PET/CT combined with inflammatory index for major pathological reactions in resectable NSCLC receiving neoadjuvant immunochemotherapy
Xiaoqin Yin, Jian Li, Bei Chen, Kehuang Liu, Shuo Hu
Lung Cancer.2023; 186: 107389. CrossRef - Efficacy, safety, and survival of neoadjuvant immunochemotherapy in operable non-small cell lung cancer: a systematic review and meta-analysis
Yue Zheng, Baijie Feng, Jingyao Chen, Liting You
Frontiers in Immunology.2023;[Epub] CrossRef - Emerging Blood-Based Biomarkers for Predicting Immunotherapy Response in NSCLC
Ana Oitabén, Pablo Fonseca, María J. Villanueva, Carme García-Benito, Aida López-López, Alberto Garrido-Fernández, Clara González-Ojea, Laura Juaneda-Magdalena, Martín E. Lázaro, Mónica Martínez-Fernández
Cancers.2022; 14(11): 2626. CrossRef
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