Japanese Lung Cancer Society Guidelines for Stage IV NSCLC With EGFR Mutations
Autor: | Junko Tanizaki, Haruko Daga, Masahiro Morise, Hideaki Mizutani, Tomohiro Sakamoto, Takaaki Sasaki, Chiyo K. Imamura, Keiju Aokage, Shunsuke Teraoka, Yuko Oya, Satoshi Morita, Kenichi Suzuki, Yukiko Nakamura, Takeharu Yamanaka, Kiichiro Ninomiya, Toshiyuki Kozuki, Kaname Nosaki, Yuichi Takiguchi, Toyoaki Hida, Hitomi Nishimoto, Satoru Miura, Satoshi Oizumi, Shinsuke Amano, Yoshitaka Zenke, Hisashi Tanaka, Yasushi Goto, Yusuke Okuma, Kentaro Tanaka, Noriyuki Ebi, Katsuyuki Hotta, Eisaku Miyauchi, Kazuo Hasegawa, O. Yamaguchi, Kazuko Nakajima, Akihiro Tamiya, Hirotsugu Kenmotsu |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
Oncology medicine.medical_specialty medicine.medical_treatment Review Article Guidelines lcsh:RC254-282 Internal medicine Medicine Non–small cell lung cancer Osimertinib Epidermal growth factor receptor Lung cancer Grading (tumors) Chemotherapy biology business.industry lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease respiratory tract diseases Systematic review Egfr mutation biology.protein business Stage iv |
Zdroj: | JTO Clinical and Research Reports JTO Clinical and Research Reports, Vol 2, Iss 1, Pp 100107-(2021) |
ISSN: | 2666-3643 |
Popis: | Patients with NSCLC in East Asia, including Japan, frequently contain EGFR mutations. In 2018, we published the latest full clinical practice guidelines on the basis of those provided by the Japanese Lung Cancer Society Guidelines Committee. The purpose of this study was to update those recommendations, especially for the treatment of metastatic or recurrent EGFR-mutated NSCLC. We conducted a literature search of systematic reviews of randomized controlled and nonrandomized trials published between 2018 and 2019 that multiple physicians had reviewed independently. On the basis of those studies and the advice from the Japanese Society of Lung Cancer Expert Panel, we developed updated guidelines according to the Grading of Recommendations, Assessment, Development, and Evaluation system. We also evaluated the benefits of overall and progression-free survival, end points, toxicities, and patients' reported outcomes. For patients with NSCLC harboring EGFR-activating mutations, the use of EGFR tyrosine kinase inhibitors (EGFR TKIs), especially osimertinib, had the best recommendation as to first-line treatment. We also recommended the combination of EGFR TKI with other agents (platinum-based chemotherapy or antiangiogenic agents); however, it can lead to toxicity. In the presence of EGFR uncommon mutations, except for an exon 20 insertion, we also recommended the EGFR TKI treatment. However, we could not provide recommendations for the treatment of EGFR mutations with immune checkpoint inhibitors, including monotherapy, and its combination with cytotoxic chemotherapy, because of the limited evidence present in the literature. The 2020 Japanese Lung Cancer Society Guidelines can help community-based physicians to determine the most appropriate treatments and adequately provide medical care to their patients. |
Databáze: | OpenAIRE |
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