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The value of local consolidative therapy in Osimertinib-treated non-small cell lung cancer with oligo-residual disease
Zhengfei ZHU
Fudan University Shanghai Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7537-3619
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background: There was no study investigating real-world utilization and outcome of LCT in Osimertinib-treated NSCLC with oligo-residual disease. This study was to analyze the clinical value of local consolidative therapy (LCT) in Osimertinib-treated non-small cell lung cancer (NSCLC) patients with oligo-residual disease.
Methods: Patients receiving standard Osimertinib treatment and developing oligo-residual disease (five or fewer residual metastatic lesions) were retrospectively reviewed. Local therapies performed to the oligo-residual tumor lesions or primary lung site before Osimertinib treatment failure were considered as LCT.
Results: Of 108 patients recruited, first-line and second-line Osimertinib were administered in 25 and 83 patients, respectively, while LCT was performed in 14 patients. With a median follow-up of 43.6 months, 69 patients developed progressive disease. LCT significantly improved progression-free survival (PFS) (NR vs 12.8 months, p=0.01) and was independently associated with prolonged PFS (HR=0.29, 95%CI 0.12 to 0.68, p=0.004). Patients receiving LCT had a numerically longer overall survival (OS) (85.8 vs 77.1 months, p=0.58) and after adjusting for potentially confounding factors, LCT was associated with a non-significantly prolonged OS (HR=0.37, 95%CI 0.12-1.16, p=0.089). Pattern of failure analyses indicated that progressive disease developed at the originally existed oligo-residual lesions in 76.2% of the 63 patients who didn’t receive LCT and had Osimertinib treatment failure. Of note, 7 (70%) of the 10 patients who had oligo-residual cranial disease but didn’t receive LCT, developed more than five progressive lesions in the brain, which were no longer suitable for stereotactic radiosurgery.
Conclusion: Among Osimertinib-treated NSCLC patients having oligo-residual lesions, LCT could improve local control and significantly increase PFS, which need to be verified by further investigations.
Keywords
Non-small cell lung cancer, Osimertinib, Oligo-residual disease, Local consolidative therapy
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CURRENT STATUS: Published
Version 2
Posted 07 Aug, 2020
Published
On 27 Aug, 2020
No community comments so far
Editorial decision: Accept
On 15 Aug, 2020
Review #2 received
Received 13 Aug, 2020
Reviewer #2 agreed
On 04 Aug, 2020
Reviewers invited
Invitations sent on 03 Aug, 2020
Reviewer #1 agreed
On 03 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Editor assigned
On 31 Jul, 2020
Submission checks complete
On 30 Jul, 2020
Editor invited
On 30 Jul, 2020
No comments provided
Review #2 received
Received 21 Jul, 2020
Editorial decision: Major revision
On 21 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Review #1 received
Received 07 Jul, 2020
Reviewers invited
Invitations sent on 06 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
First submitted
On 08 Jun, 2020
Editor assigned
On 08 Jun, 2020
Submission checks complete
On 07 Jun, 2020
Editor invited
On 07 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
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This preprint is under consideration at Radiation Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
The value of local consolidative therapy in Osimertinib-treated non-small cell lung cancer with oligo-residual disease
Zhengfei ZHU
Fudan University Shanghai Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7537-3619
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 07 Aug, 2020
Published
On 27 Aug, 2020
No community comments so far
Editorial decision: Accept
On 15 Aug, 2020
Review #2 received
Received 13 Aug, 2020
Reviewer #2 agreed
On 04 Aug, 2020
Reviewers invited
Invitations sent on 03 Aug, 2020
Reviewer #1 agreed
On 03 Aug, 2020
Review #1 received
Received 03 Aug, 2020
Editor assigned
On 31 Jul, 2020
Submission checks complete
On 30 Jul, 2020
Editor invited
On 30 Jul, 2020
No comments provided
Review #2 received
Received 21 Jul, 2020
Editorial decision: Major revision
On 21 Jul, 2020
Reviewer #2 agreed
On 09 Jul, 2020
Review #1 received
Received 07 Jul, 2020
Reviewers invited
Invitations sent on 06 Jul, 2020
Reviewer #1 agreed
On 06 Jul, 2020
First submitted
On 08 Jun, 2020
Editor assigned
On 08 Jun, 2020
Submission checks complete
On 07 Jun, 2020
Editor invited
On 07 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background: There was no study investigating real-world utilization and outcome of LCT in Osimertinib-treated NSCLC with oligo-residual disease. This study was to analyze the clinical value of local consolidative therapy (LCT) in Osimertinib-treated non-small cell lung cancer (NSCLC) patients with oligo-residual disease.
Methods: Patients receiving standard Osimertinib treatment and developing oligo-residual disease (five or fewer residual metastatic lesions) were retrospectively reviewed. Local therapies performed to the oligo-residual tumor lesions or primary lung site before Osimertinib treatment failure were considered as LCT.
Results: Of 108 patients recruited, first-line and second-line Osimertinib were administered in 25 and 83 patients, respectively, while LCT was performed in 14 patients. With a median follow-up of 43.6 months, 69 patients developed progressive disease. LCT significantly improved progression-free survival (PFS) (NR vs 12.8 months, p=0.01) and was independently associated with prolonged PFS (HR=0.29, 95%CI 0.12 to 0.68, p=0.004). Patients receiving LCT had a numerically longer overall survival (OS) (85.8 vs 77.1 months, p=0.58) and after adjusting for potentially confounding factors, LCT was associated with a non-significantly prolonged OS (HR=0.37, 95%CI 0.12-1.16, p=0.089). Pattern of failure analyses indicated that progressive disease developed at the originally existed oligo-residual lesions in 76.2% of the 63 patients who didn’t receive LCT and had Osimertinib treatment failure. Of note, 7 (70%) of the 10 patients who had oligo-residual cranial disease but didn’t receive LCT, developed more than five progressive lesions in the brain, which were no longer suitable for stereotactic radiosurgery.
Conclusion: Among Osimertinib-treated NSCLC patients having oligo-residual lesions, LCT could improve local control and significantly increase PFS, which need to be verified by further investigations.
Figure 1
Figure 2
Figure 3
Figure 4