Publications by authors named "Geechen Chang"
Background/objectives: Osimertinib is a standard sequential therapy for advanced and recurrent Epidermal Growth Factor Receptor (EGFR)-mutant non-small-cell lung cancer (NSCLC) patients with the T790M mutation, following treatment with first- or second-generation EGFR Tyrosine Kinase Inhibitors (TKIs). This study aims to investigate the differences in clinical outcomes between osimertinib as a 2nd-line treatment and as a ≥3rd-line treatment in this patient population.
Methods: Between September 2014 and March 2023, we enrolled advanced and recurrent T790M + NSCLC patients who had received osimertinib as sequential treatment for analysis.
Article Synopsis
- * Results showed that a higher PRS was more strongly related to EGFR-positive LUAD cases (OR=8.63) than to EGFR-negative cases (OR=3.50), indicating a significant association based on mutation status.
- * These findings imply that genetic susceptibility to LUAD differs in never-smoking East Asian women depending on whether the cancer has specific mutations, which could affect public health strategies and clinical practices.*
Article Synopsis
- * Key factors associated with worse progression-free survival (PFS) included driver gene mutations, being classified as Eastern Cooperative Oncology Group performance status 2, and having stage II-IIIB tumors.
- * Despite the increased risk of disease progression linked to driver gene mutations, those receiving driver gene-targeted therapy showed improved post-progression survival rates, suggesting that early testing for these mutations could be beneficial in treatment planning.
Background: Bevacizumab is extensively used in the treatment of advanced non-small-cell lung cancer (NSCLC). Numerous clinical trials have proven the clinical efficacies of bevacizumab biosimilars (BB).
Objective: Our study aimed to compare the clinical outcomes between bevacizumab reference product (RP) and BB among advanced NSCLC patients in a real-world setting.
Background: The clinical outcomes of patients with anaplastic lymphoma kinase-positive (ALK+) advanced lung adenocarcinoma vary according to real-world data.
Objective: In this study, we aimed to investigate the treatment discontinuation (TTD) and overall survival (OS) of patients with ALK+ advanced lung adenocarcinoma treated with first-line ALK-TKIs in Taiwan.
Patients And Methods: This retrospective study evaluated all advanced lung adenocarcinoma patients registered in the National Taiwan Cancer Registry from 2017 to 2020 who had ALK rearrangement and received ALK-TKI treatment, using data from Taiwan's National Health Insurance Research Database (NHIRD).
Purpose: Tissue-based next-generation sequencing (NGS) analysis is highly recommended for patients with advanced/metastatic non-small cell lung cancer (NSCLC). We investigated a specific patient population with NSCLC that required tissue-based NGS analysis.
Materials And Methods: We enrolled 500 patients with advanced/metastatic (1) epidermal growth factor receptor () mutations or anaplastic large-cell lymphoma kinase () rearrangement-positive NSCLC who had failed at minimum one line of tyrosine kinase inhibitor (TKI) therapy, (2) -negative nonsquamous, and (3) non- or light-smoker patients with squamous NSCLC who were treatment-naïve or had failed at maximum two lines of systemic treatment.
Article Synopsis
- A cohort study investigated the impact of next-generation sequencing (NGS) on survival in advanced lung adenocarcinoma, including 424 patients divided into four treatment groups based on NGS testing timing and mutation status.
- Targetable mutations were found in 76.6% of treatment-naïve patients undergoing upfront NGS, with mutation-targeted therapies administered to a significantly higher percentage of these patients compared to those in other groups.
- Patients receiving mutation-targeted treatments showed improved overall survival, particularly in the upfront NGS group, highlighting the varying benefits and opportunities for NGS-based treatments across different patient populations.
Article Synopsis
- * The newly developed multi-ancestry PRS showed a strong correlation with LUAD risk, indicating that individuals in the highest PRS percentile had significantly increased risk compared to those in the lowest.
- * Findings suggest that those in the highest risk category have a lifetime risk of about 6.69%, and they reach the average population's 10-year risk for LUAD by age 41, highlighting the importance of multi-ancestry PRS for better risk assessment in this group.
Article Synopsis
- - The study investigates the effectiveness of amivantamab plus lazertinib compared to osimertinib in treating patients with advanced non-small-cell lung cancer (NSCLC) caused by specific genetic mutations.
- - Results showed that patients receiving the amivantamab-lazertinib treatment had a significantly longer progression-free survival (23.7 months) than those on osimertinib (16.6 months), and the response rate was similar among both groups.
- - Side effects primarily related to treatment were noted, but the overall survival analysis indicated a potential benefit for amivantamab-lazertinib over osimertinib, with fewer serious complications leading to treatment discontinuation.
Osimertinib has demonstrated efficacy in patients with epidermal growth factor receptor (EGFR) T790M-positive non-small cell lung cancer (NSCLC) in clinical trials. However, real-world data on its effectiveness remain scarce. Taiwanese patients with T790M-positive locally advanced or metastatic NSCLC and progressive disease following treatment with at least one EGFR tyrosine kinase inhibitor (TKI) were enrolled from the osimertinib early access program.
View Article and Find Full Text PDFIntroduction: For patients with unresectable, stage III non-small-cell lung cancer (NSCLC), current standard of care is concurrent chemoradiotherapy (cCRT) followed by consolidation durvalumab. However, earlier initiation of durvalumab simultaneously with cCRT may increase antitumor activity relative to initiation after cCRT. The phase 1 CLOVER study (NCT03509012) evaluated durvalumab combined with cCRT in patients with advanced solid tumors; we report findings from the NSCLC cohort.
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- Lorlatinib is a third-generation ALK inhibitor used to treat patients with advanced non-small cell lung cancer who have not responded to prior ALK-targeted therapies, particularly in Taiwan.
- A study involving 63 patients followed their treatment outcomes and safety after switching to lorlatinib, revealing that a high percentage had brain metastases and many had undergone multiple prior therapies.
- Results showed that lorlatinib led to a median progression-free survival of 9.2 months, with an 80.4% disease control rate, indicating it is both effective and well-tolerated in heavily pretreated patients.
Article Synopsis
- Patients with advanced EGFR-mutant lung adenocarcinoma often develop drug resistance after treating with EGFR-tyrosine kinase inhibitors (TKIs) like osimertinib.
- A study assessed the impact of primary tumor consolidative therapy (PTCT) on progression-free and overall survival among patients who responded to initial osimertinib treatment.
- Results showed that those receiving PTCT had significantly longer progression-free survival (30.3 months vs. 18.2 months) and overall survival, highlighting PTCT as a beneficial treatment option for improving outcomes in this patient group.
Article Synopsis
- In Taiwan, a study called TALENT is examining the effectiveness of low-dose CT (LDCT) screening for lung cancer in never-smokers who have other risk factors, as nearly 60% of such patients are diagnosed at advanced stages.
- The study involved 17 medical centers and included individuals aged 55-75 who met specific eligibility criteria, like having never smoked or having a very limited smoking history, and certain risk factors for lung cancer.
- Preliminary results from a 1-year follow-up after the initial LDCT screenings were analyzed, focusing on the detection rates of lung cancer and using various statistical methods to evaluate the outcomes.
Article Synopsis
- Estimating the absolute risk of lung cancer in never-smokers is key for developing effective lung cancer screening programs, particularly in relation to the influence of environmental tobacco smoke (ETS).
- This study focused on never-smoking women in Taiwan, integrating their genetic susceptibility (via a polygenic risk score) and exposure to ETS to evaluate the risk of lung adenocarcinoma (LUAD).
- Findings revealed that the estimated lifetime risk of LUAD in women with no ETS exposure was 2.5%, highlighting the variability based on genetic and environmental factors, and the study examined how these elements interact in determining lung cancer risk.
Background: Antiangiogenetic therapy and lung cancer, per se, are associated with an increased risk of thromboembolic events (TE). We aim to evaluate the pattern and outcome of TE as well as its influence on survival time of advanced non-small cell lung cancer (NSCLC) patients receiving antiangiogenic therapy.
Methods: This was a retrospective cohort study, which included advanced NSCLC patients receiving antiangiogenic therapy.
Background: Tumour differentiation is an important index for adjuvant therapy in many cancers; however, non-small cell lung cancer (NSCLC) is an exception. Furthermore, postoperative radiotherapy (PORT) is controversial in patients with NSCLC with N0-1 and N2 disease. We aimed to evaluate the impact of tumour-related factors on overall survival (OS), cancer-specific survival (CSS), and distant control (DC) in patients with completely resected stage IIIA NSCLC.
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- About 20% of stage I lung adenocarcinoma (LUAD) patients experience relapse post-surgery, with a lack of in-depth molecular studies to understand tumor characteristics.
- Researchers conducted whole exome sequencing and other analyses on 113 Taiwanese patients to identify molecular features linked to relapse-free survival (RFS), validating their findings with a separate group of Caucasian patients.
- The study discovered specific gene mutations and microRNA expressions associated with poor RFS, highlighting the potential for better prognostic tools and precision treatment options for stage I LUAD patients.
Introduction: Lorlatinib, a third-generation ALK tyrosine kinase inhibitor, improved outcomes compared with crizotinib in patients with previously untreated ALK-positive advanced NSCLC in the phase 3 CROWN study. Here, we investigated response correlates using plasma circulating tumor DNA (ctDNA) and tumor tissue profiling.
Methods: ALK fusions and ALK with or without TP53 mutations were assessed by next-generation sequencing.
Article Synopsis
- The study examines how a family history of lung cancer affects screening for the disease using low-dose computed tomography (LDCT), following participants over multiple years.
- A total of 1,102 participants were enrolled, and the overall lung cancer detection rate was 4.5%, with higher rates observed in families with multiple lung cancer cases and among never-smokers.
- The findings suggest that having a maternal relative with lung cancer significantly increases the risk, highlighting the need for further research through randomized controlled trials to determine if LDCT screening can reduce mortality in this high-risk group.
Article Synopsis
- - The RELAY trial assessed the effectiveness and safety of ramucirumab combined with erlotinib (RAM+ERL) versus erlotinib and placebo (PBO+ERL) in Taiwanese patients with untreated stage IV EGFR-mutated non-small cell lung cancer, showing that RAM+ERL significantly improved progression-free survival (PFS).
- - Out of 56 Taiwanese participants, RAM+ERL led to a median PFS of 22.05 months compared to 13.40 months for PBO+ERL, and the overall response rate (ORR) was 92% for RAM+ERL compared to 60% for PBO+ERL, indicating better treatment outcomes. *
Article Synopsis
- Lung adenocarcinoma is the most prevalent form of lung cancer, and existing known genetic risk factors account for only a small portion of its heritability.
- A comprehensive genome-wide association study involving nearly 22,000 cases and over 150,000 controls identified 12 new genetic variants linked to the disease, raising the count to 28 variants across 25 distinct locations in the genome.
- The study emphasized that these genetic markers are particularly significant in East Asian populations, especially among never-smokers, and indicates that further research could inform better prevention and treatment strategies tailored to these populations.
Introduction: Lorlatinib is a potent, third-generation inhibitor of ALK. In the planned interim analysis of the ongoing, phase 3, randomized, global CROWN trial (NCT03052608), lorlatinib resulted in significantly longer progression-free survival than crizotinib in patients with previously untreated, advanced, -positive NSCLC. Here, we present a subgroup analysis of Asian patients in the CROWN study.
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- The study investigates the significance of serum neutrophil-to-lymphocyte ratio (NLR) as a prognostic biomarker in advanced -mutant non-small cell lung cancer (NSCLC) patients treated with osimertinib.
- A total of 112 treatment-naïve patients were examined, revealing that a high baseline NLR (≥ 5) was linked to poorer progression-free survival (20.5 months) and overall survival (47.3 months).
- The findings suggest that patients with high NLR had more metastases, particularly outside the chest, leading to worse outcomes, indicating NLR could be vital in predicting patient prognosis in this treatment context.