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A new, potential and safe neoadjuvant therapy strategy in epidermal growth factor receptor mutation-positive
Baoxing Liu1, Xingyu Liu1, Huifang Xing2
1Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
Background:
Studies of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in resectable non-small-cell lung cancer (NSCLC) have been conducted. The purpose of our study was to evaluate the benefits of osimertinib as neoadjuvant therapy for resectable EGFR-mutated NSCLC.
Method:
This retrospective study evaluated patients with EGFR mutations in exon 19 or 21 who received targeted therapy with osimertinib (80 mg per day) before surgery between January 2019 and October 2023 in Henan Cancer Hospital.
Results:
Twenty patients were evaluated, all of whom underwent surgery. The rate of R0 resection was 100% (20/20). The objective response rate was 80% (16/20), and the disease control rate was 95% (19/20). Postoperative pathological analysis showed a 25% (5/20) major pathological response rate and 15% (3/20) pathological complete response rate. In total, 25% (5/20) developed adverse events (AEs), and the rate of grades 3-4 AEs was 10% (2/20). One patient experienced a grade 3 skin rash, and 1 patient experienced grade 3 diarrhea.
Conclusion:
Osimertinib as neoadjuvant therapy for resectable EGFR-mutated NSCLC is safe and well tolerated. Osimertinib has the potential to improve the radical resection rate and prognosis.
Insights
Neoadjuvant osimertinib shows promise for resectable EGFR-mutated non-small-cell lung cancer (NSCLC). This therapy is safe, well-tolerated, and may improve surgical outcomes and patient prognosis.
Area of Science:
- Oncology
- Medical Science
Background:
- Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are studied in resectable non-small-cell lung cancer (NSCLC).
- EGFR mutations are key drivers in a subset of NSCLC patients.
Purpose of the Study:
- To evaluate the efficacy and safety of osimertinib as neoadjuvant therapy.
- To assess the impact of neoadjuvant osimertinib on surgical outcomes in resectable EGFR-mutated NSCLC.
Main Methods:
- Retrospective study of 20 patients with EGFR mutations (exon 19 or 21).
- Patients received neoadjuvant osimertinib (80 mg/day) prior to surgical resection.
- Data collected from January 2019 to October 2023 at Henan Cancer Hospital.
Main Results:
- 100% R0 resection rate achieved.
- Objective response rate was 80%, with a 95% disease control rate.
- Major pathological response rate was 25%, and pathological complete response rate was 15%.
- 25% of patients experienced adverse events, with 10% experiencing grade 3 events (skin rash, diarrhea).
Conclusions:
- Neoadjuvant osimertinib is safe and well-tolerated in resectable EGFR-mutated NSCLC.
- Osimertinib demonstrates potential to enhance radical resection rates and improve patient prognosis.
- Further research is warranted to confirm these findings in larger cohorts.
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