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1.
J Thorac Oncol ; 2024 Jun 14.
Article in English | MEDLINE | ID: mdl-38880172

ABSTRACT

BACKGROUND: There is limited literature on the prevalence of EGFR mutations in early-stage non-small cell lung cancer (NSCLC). EARLY-EGFR (NCT04742192), a cross-sectional study, determined the prevalence of EGFR mutations in early-stage NSCLC. METHODS: This non-interventional, real-world study enrolled consecutive patients with resected stage IA-IIIB (American Joint Committee on Cancer 8th edition) NSCLC from 14 countries across Asia, Latin America, and Middle East and Africa. The primary endpoint was prevalence of EGFR mutations and secondary endpoints included prevalence of EGFR mutation subtypes and treatment patterns. RESULTS: Of 601 patients (median [range] age: 62.0 [30.0-86.0] years) enrolled, 52.7% were females and 64.2% were non-smokers. The majority had stage IA-IB NSCLC (64.1%) and adenocarcinoma histology (98.7%). Overall prevalence of EGFR mutations was 51.0%; majority reported exon-19 deletions (48.5%) followed by exon-21 L858R mutations (34.0%). Women had a higher EGFR mutation rate than men (64.0% versus 36.4%). Compared with no EGFR mutations, patients with EGFR mutations were more likely to be non-smokers (35.1% versus 60.9%) and have stage I NSCLC compared to stage II and III NSCLC (54.8% versus 47.3% and 35.6%). Systemic adjuvant therapy was planned in 33.8% patients with stage IB to IIIB disease and adjuvant chemoradiotherapy in 6.8% patients. Age ≥60 years, females, and Asians were found to have a significantly (p < 0.05) higher odds of EGFR mutations, while smoking history and stage III disease had lower odds of EGFR mutations. CONCLUSION: The EARLY-EGFR study provides an overview of EGFR mutations and subtype prevalence in patients with early-stage NSCLC. The study highlights the limited adherence to treatment guidelines suggesting an unmet need for improved adjuvant therapy.

2.
Cancer Med ; 12(2): 1247-1259, 2023 01.
Article in English | MEDLINE | ID: mdl-35789068

ABSTRACT

INTRODUCTION: Stage III non-small-cell lung cancer (NSCLC) management is challenging given the heterogeneous nature of the disease. The LATAM subset of the real-world, global KINDLE study reported the treatment patterns and clinical outcomes for LATAM from the pre-immuno-oncology era. METHODS: The study was conducted in seven countries (Argentina, Chile, Colombia, Dominican Republic, Mexico, Peru and Uruguay) in stage III NSCLC (American Joint Committee on Cancer, 7th edition) diagnosed between January 2013 and December 2017. Retrospective data from patients' medical records (index date to the end of follow-up) were collected. Summary statistics, Kaplan-Meier survival estimates and a two-sided 95% confidence interval (CI) were provided. Cox proportional hazard model was used for univariate and multi-variate analyses. RESULTS: A total of 231 patients was enrolled, the median age was 65.0 years (range 21.0-89.0), 60.6% were males, 76.6% had smoking history, 64.0% had adenocarcinoma and 28.7% underwent curative resection. Multiple treatment regimens (>25) were used; chemotherapy alone was the most common (24.8%). The overall median progression-free survival (mPFS) and median overall survival (mOS) were 14.8 months (95% CI, 12.1-18.6) and 48.6 months (95% CI, 34.7 to not calculable). Significantly better mPFS and mOS were observed for stage IIIA with curative surgery and resectable tumours and stage IIIB with an Eastern Cooperative Oncology Group score of 0/1, female gender, resectable tumours, adenocarcinoma and curative surgery (p < 0.05). CONCLUSION: Results show diversity in treatment practices and the corresponding clinical outcomes in stage III NSCLC. There is a need to streamline treatment selection and sequencing to decrease relapse rates after initial therapy.


Subject(s)
Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Male , Humans , Female , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Latin America , Retrospective Studies , Neoplasm Recurrence, Local/pathology , Adenocarcinoma/pathology , Neoplasm Staging
3.
Patient Prefer Adherence ; 16: 1201-1211, 2022.
Article in English | MEDLINE | ID: mdl-35592774

ABSTRACT

Purpose: Despite newer type 2 diabetes (T2D) medications, patients do not always achieve metabolic targets, remaining at risk for cardiorenal complications. Therapeutic decisions are generally made by the healthcare team without considering patients' preferences. We aimed to evaluate patients' T2D treatment preference in two Latin-American countries between two different oral medication profiles, one resembling dipeptidyl peptidase-4 inhibitors (DPP4i) and another resembling sodium-glucose cotransporter-2 inhibitors (SGLT2i). Patients and Methods: In this cross-sectional, multicenter study from June to September 2020, patients with T2D from Argentina and Mexico (n = 390) completed a discrete choice experiment questionnaire to identify preferences between DPP4i (medication profile A) and SGLT2i (medication profile B). The reason behind patients' choice, and the association between their baseline characteristics and their preference were evaluated using logistic regression methods. Results: Most participants (88.2%) preferred SGLT2i's profile. Participants with older age (p = 0.0346), overweight or obesity (p < 0.0001), high blood pressure (BP; p < 0.0001), high total cholesterol (p = 0.0360), and glycosylated hemoglobin (HbA1c) <7% (p = 0.0001) were more likely to choose SGLT2i compared with DPP4i's profile. The most and least important reasons to choose either drug profile were HbA1c reduction and genital infection risk, respectively. The likelihood of selecting the SGLT2i's profile significantly increased in participants with increased body mass index (BMI; odds ratio [OR] = 8.9, 95% confidence interval [CI]: 3.5-22.5, p < 0.05), high BP (OR = 4.9, 95% CI: 1.9-12.4, p < 0.05), and lower education level (OR = 3.6, 95% CI: 1.0-12.6, p < 0.05). Conclusion: Latin-American patients with T2D preferred medication with a profile resembling SGLT2i over one resembling DPP4i as a treatment option. A patient-centered approach may aid the healthcare team in decision-making for improved outcomes.

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