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Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer

INTRODUCTION: The treatment of lung cancer is not defined in the third-line setting and remains an unanswered question. Erlotinib is the only drug approved in the third-line setting. With the introduction of effective first- and second-line therapies, more and more patients warrant an effective thir...

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Autores principales: Noronha, Vanita, Pande, Nikhil, Joshi, Amit, Patil, Vijay, Trivedi, Vaishakhi, Chougule, Anuradha, Janu, Amit, Mahajan, Abhishek, Talreja, Vikas, Prabhash, Kumar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956591/
https://www.ncbi.nlm.nih.gov/pubmed/31956622
http://dx.doi.org/10.4103/sajc.sajc_28_19
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author Noronha, Vanita
Pande, Nikhil
Joshi, Amit
Patil, Vijay
Trivedi, Vaishakhi
Chougule, Anuradha
Janu, Amit
Mahajan, Abhishek
Talreja, Vikas
Prabhash, Kumar
author_facet Noronha, Vanita
Pande, Nikhil
Joshi, Amit
Patil, Vijay
Trivedi, Vaishakhi
Chougule, Anuradha
Janu, Amit
Mahajan, Abhishek
Talreja, Vikas
Prabhash, Kumar
author_sort Noronha, Vanita
collection PubMed
description INTRODUCTION: The treatment of lung cancer is not defined in the third-line setting and remains an unanswered question. Erlotinib is the only drug approved in the third-line setting. With the introduction of effective first- and second-line therapies, more and more patients warrant an effective third-line therapy. We did a post hoc analysis of our randomized trial for the epidermal growth factor receptor (EGFR)-positive patients who received third-line therapy. MATERIALS AND METHODS: The present series is of 85 patients who received third-line therapy. Demographic data were collected which included age, performance status, gender, stage, comorbidities, and sites of metastasis. Data were collected for the type of systemic treatment patients received and number of cycles received. Information related to the impact of treatment on the symptoms of patients and the imaging done for response evaluation was collected. RESULTS: Of the 85 patients, there were 13 patients (15%) who achieved a partial response and 34 patients (40%) who had stable disease as best response. There were no complete response and 20 patients (24%) had disease progression at the time of first assessment. The median overall survival (OS) was 8.36 months (95% confidence interval [CI] 6.8–9.8 months) and median progression-free survival was 4.4 months (95% CI 3.3–4.9 months). Grade 3 or 4 toxicities were seen in 42.5% (n = 36) of the total patients. CONCLUSIONS: The study provides the patterns and outcomes of systemic treatment in metastatic EGFR-mutated lung adenocarcinoma in patients who have progressed on two or more lines of systemic therapies. This data suggest that third-line systemic therapy may provide meaningful outcomes in these patients.
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spelling pubmed-69565912020-01-17 Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer Noronha, Vanita Pande, Nikhil Joshi, Amit Patil, Vijay Trivedi, Vaishakhi Chougule, Anuradha Janu, Amit Mahajan, Abhishek Talreja, Vikas Prabhash, Kumar South Asian J Cancer ORIGINAL ARTICLE: Lung Cancers INTRODUCTION: The treatment of lung cancer is not defined in the third-line setting and remains an unanswered question. Erlotinib is the only drug approved in the third-line setting. With the introduction of effective first- and second-line therapies, more and more patients warrant an effective third-line therapy. We did a post hoc analysis of our randomized trial for the epidermal growth factor receptor (EGFR)-positive patients who received third-line therapy. MATERIALS AND METHODS: The present series is of 85 patients who received third-line therapy. Demographic data were collected which included age, performance status, gender, stage, comorbidities, and sites of metastasis. Data were collected for the type of systemic treatment patients received and number of cycles received. Information related to the impact of treatment on the symptoms of patients and the imaging done for response evaluation was collected. RESULTS: Of the 85 patients, there were 13 patients (15%) who achieved a partial response and 34 patients (40%) who had stable disease as best response. There were no complete response and 20 patients (24%) had disease progression at the time of first assessment. The median overall survival (OS) was 8.36 months (95% confidence interval [CI] 6.8–9.8 months) and median progression-free survival was 4.4 months (95% CI 3.3–4.9 months). Grade 3 or 4 toxicities were seen in 42.5% (n = 36) of the total patients. CONCLUSIONS: The study provides the patterns and outcomes of systemic treatment in metastatic EGFR-mutated lung adenocarcinoma in patients who have progressed on two or more lines of systemic therapies. This data suggest that third-line systemic therapy may provide meaningful outcomes in these patients. Wolters Kluwer - Medknow 2020 /pmc/articles/PMC6956591/ /pubmed/31956622 http://dx.doi.org/10.4103/sajc.sajc_28_19 Text en Copyright: © 2019 The South Asian Journal of Cancer http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle ORIGINAL ARTICLE: Lung Cancers
Noronha, Vanita
Pande, Nikhil
Joshi, Amit
Patil, Vijay
Trivedi, Vaishakhi
Chougule, Anuradha
Janu, Amit
Mahajan, Abhishek
Talreja, Vikas
Prabhash, Kumar
Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title_full Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title_fullStr Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title_full_unstemmed Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title_short Third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
title_sort third-line therapy in the epidermal growth factor receptor mutation-positive advanced nonsmall-cell lung cancer
topic ORIGINAL ARTICLE: Lung Cancers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6956591/
https://www.ncbi.nlm.nih.gov/pubmed/31956622
http://dx.doi.org/10.4103/sajc.sajc_28_19
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