Publications by authors named "Hsu Kuo-Hsuan"
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
- * 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.
Article Synopsis
- This study explores the potential of genetic factors, specifically polygenic risk scores (PRSs), in improving lung cancer screening in Taiwan by identifying individuals at higher risk for non-small cell lung cancer (NSCLC).
- A retrospective analysis of 2,287 participants revealed that while age was the only risk factor for men, women showed risks related to age, family history, and higher PRS levels, suggesting a need for tailored screening approaches.
- The use of PRS improved the predictive accuracy of NSCLC diagnosis, increasing the area under the curve (AUC) from 0.741 to 0.778, indicating the promise of integrating genetic information in lung cancer screening programs, especially for women.
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.
Lung cancer is considered the number one cause of cancer-related deaths worldwide. Although current treatments initially reduce the lung cancer burden, relapse occurs in most cases; the major causes of mortality are drug resistance and cancer stemness. Recent investigations have provided evidence that shikonin generates various bioactivities related to the treatment of cancer.
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- 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.
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.
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 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.
Introduction: For patients with T2aN0 stage IB lung adenocarcinoma, benefits of adjuvant chemotherapy remain controversial. Here, we aimed to evaluate such benefits.
Methods: This retrospective cohort study was conducted on the database of the National Taiwan Cancer Registry.
Class I small heat shock proteins (CI sHSPs), OsHsp16.9A and OsHsp18.0, share 74% identity in amino acid sequences and accumulate in response to heat shock treatments.
View Article and Find Full Text PDF(1) Background: We aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in lung cancer patients treated with tyrosine kinase inhibitor (TKI), particularly in those with resolved HBV infection. (2) Methods: In this retrospective hospital-based cohort study, we screened all lung cancer patients with positive hepatitis B core antibodies (anti-HBc) receiving systemic antineoplastic treatment during the period from January 2011 to December 2020. Cumulative incidences of HBV reactivation, and their hazard ratios (HRs), were evaluated after adjusting patient mortality as a competing risk.
View Article and Find Full Text PDFObjective: Immunotherapy plus etoposide and platinum (EP)-based chemotherapy is the standard of care for patients with extensive stage-small cell lung carcinoma (ES-SCLC). In the era of immunotherapy, the role of thoracic radiotherapy for ES-SCLC remains unclear.
Methods: We retrospectively included ES-SCLC patients treated with first-line EP-based chemotherapy plus atezolizumab or durvalumab at Taichung Veterans General Hospital to evaluate the prognostic role and safety of thoracic radiotherapy.
We aimed to evaluate whether different driver mutations have varying impacts on the programmed cell death-ligand 1 (PD-L1) expression of non-small cell lung cancer (NSCLC), and whether the prognostic roles of PD-L1 amongst our patients were divergent. This was a single-institute study that included patients with NSCLC. Six driver mutations, PD-L1 status, and the outcomes of treatment were assessed.
View Article and Find Full Text PDF: Third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) is one of the standard-of-care therapies in patients with -mutant lung adenocarcinoma; however, acquired resistance inevitably developed. Despite the proposition of histological transformation being one of the resistance mechanisms, its incidence and influence on outcome remain unclear. : This was a retrospective study conducted at Taichung Veterans General Hospital on patients with advanced -mutant lung adenocarcinoma receiving the third-generation EGFR-TKI.
View Article and Find Full Text PDFBackground: We aim to evaluate the influence of the timing of leptomeningeal metastasis (LM) occurrence on the outcome of -mutant lung adenocarcinoma and to explore the predictors of detectable mutation in the cerebrospinal fluid (CSF).
Methods: -mutant lung adenocarcinoma patients with cytologically confirmed LM were included for analysis. mutation in CSF was detected by MALDI-TOF MS plus PNA.
Article Synopsis
- KRAS mutations (KRASm) are linked to poor outcomes in non-small cell lung cancer (NSCLC), particularly in a Taiwanese population where lung adenocarcinoma is common among never-smokers.
- A study of 93 NSCLC patients revealed that the G12C mutation was the most prevalent, and PD-L1 expression was positive in 66% of those tested, with higher positivity in ever-smokers.
- Immune checkpoint inhibitors (ICIs) significantly improved overall survival rates for NSCLC patients with KRASm, especially those with high PD-L1 expression (≥50%), with median survival of 35.6 months compared to 9.8 months for those not receiving ICIs.
The impact of strong Programmed Death-ligand 1 (PD-L1) expression on the clinical outcomes of osimertinib in treatment naïve advanced Epidermal Growth Factor Receptor (EGFR)-mutant Non-small Cell Lung Cancer (NSCLC) patients remains uncertain. We enrolled advanced NSCLC patients who harbored sensitizing EGFR mutation and were treated first-line with osimertinib between 2017 and 2021. The PD-L1 expression level was also tested.
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- The study compares the efficacy of two EGFR-targeting drugs, osimertinib and afatinib, in treating advanced non-small cell lung cancer in patients with specific genetic mutations.
- A total of 128 patients were analyzed, with those on osimertinib showing a median progression-free survival of 18.8 months compared to 13.1 months for afatinib, especially benefiting patients with brain metastasis.
- Despite the findings, there was no significant evidence to suggest that osimertinib resulted in a longer overall survival compared to afatinib in this patient population.
Importance: Small cell lung carcinoma (SCLC) is uncommon in individuals who have never smoked (never-smokers). The related epidemiologic factors and prognosis remain unclear.
Objective: To assess the epidemiologic factors, clinical characteristics, and outcomes of SCLC in never-smokers.
Pulmonary cryptococcosis in the non-human immunodeficiency virus-infected population is uncommon. We aimed to explore the relevance between clinical presentations, radiological findings, and comorbidities and identify the outcome predictors. A total of 321 patients at Taichung Veterans General Hospital between 2005 and 2019 were included; of them, 204 (63.
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