Trial reportJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2019
The Unique Spatial-Temporal Treatment Failure Patterns of Adjuvant Gefitinib Therapy: A Post Hoc Analysis of the ADJUVANT Trial (CTONG 1104).
Trial report in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for the treatment of people with resected stage I to III non-small-cell lung cancer and EGFR mutation.The Cochrane database of systematic reviews · 2025Pooled it
- Adjuvant EGFR-TKIs for Patients With Resected EGFR-Mutant Non-Small Cell Lung Cancer: A Meta-Analysis of 1,283 Patients.Frontiers in oncology · 2021Pooled it
- Trial
- Adjuvant Osimertinib for Resected EGFR-Mutated Stage IB-IIIA Non-Small-Cell Lung Cancer: Updated Results From the Phase III Randomized ADAURA Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Gefitinib Versus Vinorelbine Plus Cisplatin as Adjuvant Treatment for Stage II-IIIA (N1-N2) EGFR-Mutant NSCLC: Final Overall Survival Analysis of CTONG1104 Phase III Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021Trial
- Postoperative intensity-modulated radiation therapy reduces local recurrence and improves overall survival in III-N2 non-small-cell lung cancer: A single-center, retrospective study.Cancer medicine · 2020Trial
- The Role of PD-L1 in Treatment Decision-Making for Perioperative EGFR-Mutated Lung Cancer and its Genomic Analysis.Annals of surgical oncology · 2026Article
- Induction alectinib or crizotinib for stage III NSCLC harboring ALK fusion: A study with 4-year follow-up.Chinese medical journal · 2026Article
- Craniocerebral radiotherapy for EGFR-mutant non-small cell lung cancer with brain metastasis: Current evidence and future perspectives on therapeutic strategies (Review).Molecular and clinical oncology · 2025Article
- Risk factors for type I leptomeningeal metastasis derived from non-small cell lung cancer and the impact of treatment for brain metastases on its development.Neuro-oncology practice · 2025Article
- Combination of antiangiogenic and systemic therapy in advanced non-small cell lung cancer: before and after progression to leptomeningeal metastasis.Scientific reports · 2025Article
- Follow-up Analysis Enhances Understanding of Molecular Residual Disease in Localized Non-Small Cell Lung Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025Article
- Perioperative Treatment in EGFR-Mutant Early-Stage Non-Small Cell Lung Cancer: Current Evidence and Future Perspectives.Thoracic cancer · 2025Review
- Gene mutation, clinical characteristics and pathology in resectable lung adenocarcinoma.World journal of surgical oncology · 2025Article
- Real-World Treatment Patterns and Survival Among Patients with Stage I-III, Non-Squamous, Non-Small Cell Lung Cancer Receiving Surgery as Primary Treatment.Oncology and therapy · 2024Article
- A narrative review on perioperative systemic therapy in non-small cell lung cancer.Exploration of targeted anti-tumor therapy · 2024Review
- Expert consensus on the use of third-generation EGFR-TKIs in EGFR-mutated advanced non-small cell lung cancer with various T790M mutations post-resistance to first-/second-generation EGFR-TKIs.Therapeutic advances in medical oncology · 2024Review
- Article
- Osimertinib as first-line treatment for recurrent lung cancer patients withJournal of thoracic disease · 2023Article
- Real-world analysis of first-line afatinib in patients withTranslational lung cancer research · 2023Article
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Authors and funding
29 authors at 18 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAdjuvant gefitinib therapy prolonged disease-free survival in patients with resected early-stage EGFR-mutation positive NSCLC in the ADJUVANT study (CTONG 1104). However, treatment failure patterns after gefitinib therapy are less well characterized.
methodsOverall, 222 stage N1-N2, EGFR-mutant NSCLC patients received gefitinib or vinorelbine plus cisplatin (VP) treatment. Tumor recurrences or metastases occurring during follow-up were defined as treatment failure; sites and data of first treatment failure were recorded. A post hoc analysis of treatment failure patterns which was estimated by Kaplan-Meier and hazard rate curves in modified intention-to-treat patients was conducted.
resultsThere were 114 recurrences and 10 deaths before recurrence across 124 progression events. Spatial distribution analysis showed that the first metastasis site was most frequently the central nervous system in the gefitinib group (29 of 106 [27.4%]), extracranial metastases were most frequent in the VP group (32 of 87 [36.8%]). Temporal distribution analysis showed lower tumor recurrence with gefitinib than with VP 0 to 21 months post-surgery. However, recurrence with gefitinib showed a constant rate of increase 12 months post-surgery. The first peak of extracranial metastasis appeared during 9 to 15 months with VP and 24 to 30 months with gefitinib. The highest peak for central nervous system metastases post-surgery occurred after 12 to 18 months with VP and 24 to 36 months with gefitinib.
conclusionsAdjuvant gefitinib showed advantages over VP chemotherapy in treatment failure patterns especially in extracranial metastasis. Adjuvant tyrosine kinas inhibitors may be considered as a treatment option in resected stage N1-N2 EGFR-mutant NSCLC but longer duration should be explored.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.