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Efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in patients with recurrent non-small cell lung cancer after definitive concurrent chemoradiation or radiotherapy

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Abstract

Purpose

Whether prior radiotherapy (RT) affects the response of EGFR-mutated non-small cell lung cancer (NSCLC) to EGFR tyrosine kinase inhibitor (TKI) remains elusive.

Methods

Patients with EGFR-mutated NSCLC treated with EGFR TKIs who recurred after curative treatment at Asan Medical Center, Seoul, Korea were included. The progression-free survival (PFS) and overall survival (OS) from the initiation of EGFR TKI in patients who recurred after definitive RT were analyzed and compared to the outcomes of RT-naïve patients with advanced NSCLC treated with EGFR TKIs from previously reported prospective clinical trial results.

Results

A total of 60 patients who recurred after definitive RT were included. The median age was 70 years (range, 38–88), with 24 patients (40.0%) being males. Among the 60 patients, 52 patients (86.7%) had exon 19 deletion or L858R mutation, with 49 patients (81.7%) receiving gefitinib as the first-line EGFR TKI. The median PFS and OS from the initiation of EGFR TKI were 10.4 months (95% confidence interval [CI], 7.4–13.2) and 21.3 months (95% CI, 13.4–28.8), respectively.

Conclusion

The EGFR TKI efficacy in EGFR-mutated patients with NSCLC who recurred after RT was comparable with that in historic controls of RT-naïve patients with advanced NSCLC treated with EGFR TKIs, indicating that RT may not affect EGFR TKI efficacy.

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Acknowledgements

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea

    Jaewon Hyung, Hyunseok Yoon, Chang-Min Choi, Shinkyo Yoon, Dae Ho Lee, Sang-we Kim & Jae Cheol Lee

  2. Department of Pulmonology and Critical Care Medicine, University of Ulsan College of Medicine, Seoul, Korea

    Chang-Min Choi

  3. Department of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Seoul, Korea

    Hyeong-ryul Kim

  4. Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Su Ssan Kim & Si Yeol Song

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  1. Jaewon Hyung
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Contributions

JCL and JH: contributed to the study conception and design. Material preparation, data collection and analysis were performed by CMC, HY, JH, HK and JCL. The first draft of the manuscript was written by JH and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jae Cheol Lee.

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All procedures in studies involving human participants were performed following the ethical standards of the Institutional Review Board of Asan Medical Center and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (IRB approval no. 2021–1165).

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Hyung, J., Yoon, H., Choi, CM. et al. Efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in patients with recurrent non-small cell lung cancer after definitive concurrent chemoradiation or radiotherapy. J Cancer Res Clin Oncol 149, 4243–4251 (2023). https://doi.org/10.1007/s00432-022-04287-5

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