Improved Progression-Free Survival in Early Mutated NSC Lung Cancer with Erlotinib Interview with:

Prof. Yi-Long Wu, PI of CTONG1103 Tenured Professor of Guangdong Lung Cancer Institue, South China University of Technology (SCUT) Chair of Chinese Thoracic Oncolgy Group (CTONG)

Prof. Yi-Long Wu

Prof. Yi-Long Wu, PI of CTONG1103
Tenured Professor of Guangdong Lung Cancer Institue,
South China University of Technology (SCUT)
Chair of Chinese Thoracic Oncolgy Group (CTONG) What is the background for this study?

Response: Patients with stage IIIA-N2 non-small-cell lung cancer (NSCLC) are considerable heterogeneity with variable ipsilateral mediastinal lymph node involvement. Current treatment options for this group of NSCLC patients include surgery followed by adjuvant chemotherapy, neoadjuvant therapy followed by surgical resection or definitive chemoradiation. The optimal strategy is controversial and neoadjuvant chemotherapy only give patients more 5% 5-year survival. What are the main findings? 

Response: CTONG 1103 is the first phase II, randomised controlled trial comparing EGFR-TKI erlotinib versus doublet chemotherapy in neoadjuvant setting;

Noadjuvant erlotinib improved Overall response rate (ORR), Major pathological response (MPR), operation rate, R0 resection and Lymph node down staging in stage IIIA-N2 EGFR mutation NSCLC:

    • ORR:                     54.1% vs 34.3%;
    • MPR:                     10.7% vs 0
    • Operation rate:       83.8% vs 68.6%
    • R0 resection:          73.0% vs 62.9%;
    • LN Down staging:  10.8% vs 2.9%;

In this trial RR with 54% of erlotinib was lower than that of 70% in advanced disease. This may due to test RR in short time (only 42 days). In advanced disease setting drug efficacy was tested in whole disease course. What should readers take away from your report?

Response: This randomized clinical trial first supplied the evidences in multiple parameters that erlotinib used before surgery could improve survival with free relapse. This is new option for lymph node metastases but potential resectable non-small cell lung cancer. What recommendations do you have for future research as a result of this work?

Response: Neoadjuvant TKIs treatment in EGFR mutant NSCLC need more evidence. But it is difficult to enroll patients. In our trial total 17 hospitals joined and lasted almost 7 years. I suggest we need to explore real-word research for this setting.

My disclosure: Speaker honorarium from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Merck, Pfizer, Roche, Sanofi; Consulting/Advisory Role: AstraZeneca, Boehringer Ingelheim, Merck, Roche and Research Funding: Boehringer Ingelheim, Roche 


ESMO 2018 Congress abstract


W.-Z. Zhong1, Y.-L. Wu2, K.-N. Chen3, C. Chen4, C.-D. Gu5, Q. Wang6, J. Wang7, W. Mao8, G.-B. Qiao9, Y. Cheng10, L. Xu11, C.-L. Wang12, M.-W. Chen13, X.-N. Yang1, H.-J. Chen1, H.-H. Yang1, J.-J. Yang2, Q. Zhou2


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