Evidence map›Paper›PMID 33186889›Full record

ArticleTranslational oncology2021

Long term follow-up of EGFR mutated NSCLC cases.

Gad Rennert, Maya Gottfried, Hedy S Rennert, Flavio Lejbkowicz, Meira Frank, Ilana Cohen, Shiri Kelt, Abed Agbarya, Elizabeta Dudnik, Julia Dudnik and 10 more

Open access · goldAbstract read
In one paragraph

Article in Translational oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 10 institutions in 1 country.

Gad RennertClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Office of Chief Physician, Clalit Health Services Headquarters, Tel Aviv, Israel. Electronic address: rennert@technion.ac.il.
Maya GottfriedLung Cancer Unit, Meir Medical Center, 4428164 Kfar Saba, Israel.
Hedy S RennertClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Flavio LejbkowiczClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Meira FrankClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Ilana CohenClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Shiri KeltClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Abed AgbaryaOncology Unit, Bene Zion Medical Center, Haifa, Israel.
Elizabeta DudnikThoracic Cancer Unit, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
Julia DudnikDepartment of Oncology, Soroka University Medical Center (SUMC) and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Rivka KatznelsonInstitute of Oncology, Kaplan Medical Center, Rehovot, Israel; Faculty of Medicine, Hebrew University, Jerusalem, Israel.
Moshe MishaliLung Cancer Unit, Meir Medical Center, 4428164 Kfar Saba, Israel.
Natalie Maimon RabinovichLung Cancer Unit, Meir Medical Center, 4428164 Kfar Saba, Israel.
Hovav NechushtanSharett Institute of Oncology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel.
Amir OnnInstitute of Pulmonology, Sheba Medical Center, Tel Hashomer, Israel.
Shoshana Keren RosenbergOncology Institute, Lin Medical Center and Carmel Medical Center, Haifa, Israel.
Mariana WollnerDepartment of Oncology, Rambam Health Care Campus, Haifa, Israel.
Alona ZerThoracic Cancer Unit, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.
Jair BarSheba Medical Center, Tel Hashomer, Ramat-Gan, Israel.
Naomi GronichClalit Health Services National Cancer Control Center and Personalized Medicine Program, Israel; Department of Community Medicine and Epidemiology, Carmel Medical Center and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Technion – Israel Institute of Technology · ILMeir Medical Center · ILRabin Medical Center · ILSheba Medical Center · ILBen-Gurion University of the Negev · ILBnai Zion Medical Center · ILCarmel Medical Center · ILHadassah Medical Center · ILHebrew University of Jerusalem · ILRambam Health Care Campus · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeA substantial fraction of all non-small cell lung cancers(NSCLC) carry a mutation in the EGFR gene for which an effective treatment with anti-tyrosine kinases(TKIs) is available. We studied the long term survival of these patients following the introduction of TKIs. EXPERIMENTAL

designAll consecutive cases of NSCLC newly diagnosed with advanced disease were referred for free tumor EGFR mutation testing at Clalit's national personalized medicine laboratory. Mutations and deletions in target codons 18-21 of EGFR were sought using RT-PCR and fragment analysis. Comprehensive EMRs were used to collect full data on treatments and clinical status.

resultsA cohort of 3,062 advanced NSCLC cases, included 481(15.7%) somatic EGFR mutation carriers (17.5% of all adenocarcinomas, 26.7% of females with adenocarcinomas). TKIs treatment to EGFR mutation carriers was provided to 85% of all eligible. After a median follow up period of 15.9 months for EGFR mutated cases the hazard ratio for overall survival of EGFR-mutated NSCLC treated with TKIs was 0.55(0.49-0.63, p<0.0001) when compared with EGFR wild-type(WT) tumors under usual care. After adjusting for age, sex, ethnicity, smoking history and tumor histology, all of which had an independently significant effect on survival, the HR for TKI-treated, EGFR-mutated tumors, was 0.63 (0.55-0.71, p<0.0001). Treating EGFR-WT cases with TKIs yielded a high HR=1.32 (1.19-1.48).

conclusionsTKIs given to EGFR mutated advanced NSCLC demonstrated a substantial survival benefit for at least five years. Squamous histology, smoking, male sex and Arab ethnicity were associated with higher NSCLC mortality hazard. Treating non-EGFR-mutated NSCLC with TKIs seems detrimental. Statement of Significance: • TKIs given to EGFR mutated advanced NSCLC demonstrated a substantial survival benefit for at least five years but not much longer. • Treating non-EGFR-mutated NSCLC with TKIs seems detrimental and should probably be avoided. • Squamous histology of non-small cell lung cancer, smoking history, male sex and Arab ethnicity were associated with altogether higher NSCLC mortality hazard.

Identifiers

PMID33186889
PMCPMC7658494
OpenAlexW3105851122

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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.