This targeted drug for lung cancer reduces the risk of recurrence or death by 77%

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This targeted drug for lung cancer reduces the risk of recurrence or death by 77%

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This targeted drug for lung cancer reduces the risk of recurrence or death by 77%.

The risk of recurrence or death is reduced by 77%, and this lung cancer targeted drug has made another major breakthrough!

A major breakthrough! Announced at the 2022 European Society for Medical Oncology (ESMO) Congress: Osimertinib in adjuvant treatment of EGFR mutation-positive patients has a median disease-free survival of 5.5 years [1] ! Reduced the risk of disease recurrence or death by 77% in the primary analysis population (stage II-IIIA) .

An additional prespecified exploratory analysis showed that at 4 years, 90% of patients in the osimertinib group were disease-free in the brain and spinal cord (95% CI 85-94%).

After the latest research data was released, some questions are coming:

“Since the effect of osimertinib as a postoperative adjuvant on some EGFR mutation-positive patients is so amazing, then, which lung cancer patients need postoperative adjuvant? Because if there is no postoperative adjuvant, there is fear of recurrence , and more postoperative adjuvant is afraid of recurrence. Overtreatment. “

Postoperative recurrence rate of different lung cancer stages

Although up to 30% of patients with non-small cell lung cancer can undergo radical surgery at an early diagnosis, recurrence is still common in early-stage patients [2-3] . About half of patients with stage I-II and 3/4 of patients with stage III have recurrence within 5 years after surgery [4-5] .

Why does it recur?

It is because there are residual cancer cells in the human body, and when it encounters “stimulation”, it will reignite. The risk of recurrence and metastasis is highly correlated with the pathological stage, and the later the stage, the greater the chance of recurrence.

① Stage I: The local recurrence rate is similar to the distant recurrence rate, and the recurrence rate is about 10%.

② Stage IIb-IIIa: the local recurrence rate is 12%-15%, while the distant recurrence rate will reach 40%-60% [6] .

Reminder: Advanced age, high carcinoembryonic antigen (CEA) level, smoking history, air cavity spread, pleural invasion, intravascular invasion, multi-station lymph node metastasis, high PET-CT SUVmax value, etc., are more prone to recurrence and metastasis . In addition, if the pathological subtype is mainly solid and micropapillary, it is also a high risk factor for recurrence and metastasis [6] .

Do you need postoperative assistance?

Postoperative adjuvant therapy includes chemotherapy, targeted therapy, and immunotherapy, among which adjuvant targeted therapy is the most widely used in EGFR mutation-positive patients .

Qualified friends suggest that you do a genetic test after surgery to see the type of gene mutation, and then consider whether to accept postoperative adjuvant therapy according to your staging , whether there are high-risk factors for recurrence , and the doctor’s advice .

Postoperative assistance is not recommended

① For patients with stage IA non-small cell lung cancer, adjuvant therapy is generally not required after complete surgical resection of the lesion;

② For patients with stage IB non-small cell lung cancer, after complete surgical resection of the lesions, there are no high-risk factors, and adjuvant therapy is generally not required, and regular follow-up is sufficient.

Postoperative adjuvant is recommended

① Patients with stage IB non-small cell lung cancer have a high risk of recurrence, such as tumor thrombus in the microvessels around the tumor, positive minimal residual disease (MRD), positive circulating tumor DNA (ctDNA), tumor thrombus in the lymphatic vessels or veins at the bronchial end, tumor involvement Adjuvant therapy can be considered for visceral pleura, poorly differentiated lung cancer or mixed lung cancer with tumor size > 4 cm.

② EGFR-targeted drugs are recommended as standard adjuvant therapy for patients with stage II-IIIA EGFR mutation-positive lung cancer after surger .

At the end

After reading it, I hope that these two types of friends (stage IA and IB without high-risk factors) can put their hearts in their stomachs and stop worrying.

fter all, you who have worked hard all the way to the present are already your own anti-cancer hero. , It’s time to eat, drink, relax, it’s not a dream to go through 5 years and 10 years!

Reference:

[1]. “Dietary Guidelines for Chinese Residents (2022)” 2022 European Society for Medical Oncology (ESMO) Congress

[2]. Le Chevalier T. Adjuvant Chemotherapy for Resectable Non-Small-Cell Lung Cancer: Where is it Going? Ann Oncol. 2010;21:196-8.

[3]Cagle P, et al. Lung Cancer Biomarkers: Present Status and Future Developments. ArchivesPathology Lab Med. 2013;137:1191-1198.

[4] Pignon JP, et al. Lung Adjuvant Cisplatin Evaluation: A Pooled Analysis by the LACE Collaborative Group. J Clin Oncol. 2008;26:3552-3559.

[5] Peters, S. Lungscape: resected non-small-cell lung cancer outcome by clinical and pathological parameters. Thorac Oncol. 2014;9(11):1675-84.

[6] Research progress on recurrence and metastasis pattern of non-small cell lung cancer after radical resection [J]. Lung Cancer Journal, 2022, 25(1):8.

This targeted drug for lung cancer reduces the risk of recurrence or death by 77%

(source:internet, reference only)

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