Phase II study of stereotactic radiosurgery for the treatment of patients with oligoprogression on erlotinib

Jared Weiss; Brian Kavanagh; Allison Deal; Liza Villaruz; James Stevenson; Ross Camidge; Hossein Borghaei; Jack West; Padmini Kirpalani; David Morris; Carrie Lee; Chad V Pecot; Timothy Zagar; Thomas Stinchcombe; Nathan Pennell

doi:10.1016/j.ctarc.2019.100126

Phase II study of stereotactic radiosurgery for the treatment of patients with oligoprogression on erlotinib

Cancer Treat Res Commun. 2019:19:100126. doi: 10.1016/j.ctarc.2019.100126. Epub 2019 Feb 26.

Authors

Jared Weiss¹, Brian Kavanagh², Allison Deal³, Liza Villaruz⁴, James Stevenson⁵, Ross Camidge⁶, Hossein Borghaei⁷, Jack West⁸, Padmini Kirpalani⁹, David Morris¹⁰, Carrie Lee¹¹, Chad V Pecot¹², Timothy Zagar¹⁰, Thomas Stinchcombe¹³, Nathan Pennell¹⁴

Affiliations

¹ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
² Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
³ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁴ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁵ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁶ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁷ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁸ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
⁹ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
¹⁰ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States.
¹¹ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
¹² Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
¹³ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].
¹⁴ Lineberger Cancer Center at the University of North Carolina, 170 Manning Drive, Room 3115, Campus Box 7305, Chapel Hill, NC 27514, United States. Electronic address: [email protected].

PMID: 30852467
DOI: 10.1016/j.ctarc.2019.100126

Abstract

Introduction: Retrospective studies have evaluated the approach of stereotactic radiotherapy (SRT) to address oligoprogression in patients with EGFR mutant NSCLC on TKI therapy, it has never been prospectively studied.

Materials and methods: We treated 25 patients with EGFR mutant NSCLC on erlotinib who had 3 or fewer sites of extra-cranial progression with SRT to progressing sites, followed by re-initiation of erlotinib.

Results: Median PFS from the initiation of SRT was 6 months (95% CI 2.5 to 11.6) and median OS was 29 months (95% CI 21.7 to 36.3). Neither baseline nor changes in the Veristrat proteomic predicted PFS.

Conclusions: SRT and TKI continuation may be considered for select patients with EGFR mutant NSCLC and oligo-progression on EGFR TKI therapy.

Keywords: EGFR; Erlotinib; Oligoprogression; Stereotactic radiosurgery.

Publication types

Clinical Trial, Phase II
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Bone Neoplasms / secondary
Bone Neoplasms / therapy
Brain Neoplasms / secondary
Brain Neoplasms / therapy
Carcinoma, Non-Small-Cell Lung / pathology
Carcinoma, Non-Small-Cell Lung / therapy*
Combined Modality Therapy
Disease Progression
ErbB Receptors / antagonists & inhibitors
ErbB Receptors / genetics
Erlotinib Hydrochloride / therapeutic use*
Female
Follow-Up Studies
Humans
Liver Neoplasms / secondary
Liver Neoplasms / therapy
Lung Neoplasms / secondary
Lung Neoplasms / therapy*
Lymphatic Metastasis
Male
Middle Aged
Mutation
Prognosis
Protein Kinase Inhibitors / therapeutic use*
Radiosurgery / methods*
Survival Rate

Substances

Protein Kinase Inhibitors
Erlotinib Hydrochloride
EGFR protein, human
ErbB Receptors