Evidence map›Paper›PMID 36791768›Full record

Trial reportCancer research and treatment2023

EGFR-TKI Combined with Pemetrexed versus EGFR-TKI Monotherapy in Advanced EGFR-mutated NSCLC: A Prospective, Randomized, Exploratory Study.

Weiguang Gu, Hua Zhang, Yiyu Lu, Minjing Li, Shuang Yang, Jianmiao Liang, Zhijian Ye, Zhihua Li, Minhong He, Xiaoliang Shi and 4 more

Open access · diamondAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Cancer research and treatment, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.3field-weighted citation impact, top 11% 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

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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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

14 authors at 3 institutions in 1 country.

Weiguang GuDepartment of Oncology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China.
Hua ZhangDepartment of Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, China.
Yiyu LuDepartment of Oncology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China.
Minjing LiDepartment of Respiratory and Critical Care Medicine, The First People's Hospital of Foshan, Foshan, China.
Shuang YangDepartment of Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, China.
Jianmiao LiangDepartment of Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, China.
Zhijian YeDepartment of Respiratory and Critical Care Medicine, The First People's Hospital of Foshan, Foshan, China.
Zhihua LiDepartment of Oncology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China.
Minhong HeDepartment of Oncology, Nanhai People's Hospital/The Second School of Clinical Medicine, Southern Medical University, Foshan, China.
Xiaoliang ShiOrigiMed Co. Ltd., Shanghai, The First People's Hospital of Foshan, Foshan, China.
Fei WangOrigiMed Co. Ltd., Shanghai, The First People's Hospital of Foshan, Foshan, China.
Dong YouOrigiMed Co. Ltd., Shanghai, The First People's Hospital of Foshan, Foshan, China.
Weiquan GuDepartment of Thoracic Surgery, The First People's Hospital of Foshan, Foshan, China.
Weineng FengDepartment of Head and Neck/Thoracic Medical Oncology, The First People's Hospital of Foshan, Foshan, China.
First People's Hospital of Foshan · CNFoshan Second People's Hospital · CNSouthern Medical University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe aimed to evaluate whether the addition of pemetrexed is effective in improving progression-free survival (PFS) in epidermal growth factor receptor (EGFR)-mutated patients with or without concomitant alterations. Materials and Methods: This multicenter clinical trial was conducted in China from June 15, 2018, to May 31, 2019. A total of 92 non-small cell lung cancer (NSCLC) patients harboring EGFR-sensitive mutations were included and divided into concomitant and non-concomitant groups. Patients in each group were randomly treated with EGFR-tyrosine kinase inhibitor (TKI) monotherapy or EGFR-TKI combined with pemetrexed in a ratio of 1:1. PFS was recorded as the primary endpoint.

resultsThe overall median PFS of this cohort was 10.1 months. There were no significant differences in PFS between patients with and without concomitant and between patients received TKI monotherapy and TKI combined with pemetrexed (p=0.210 and p=0.085, respectively). Stratification analysis indicated that patients received TKI monotherapy had a significantly longer PFS in non-concomitant group than that in concomitant group (p=0.002). In concomitant group, patients received TKI combined with pemetrexed had a significantly longer PFS than patients received TKI monotherapy (p=0.013). Molecular dynamic analysis showed rapidly emerging EGFR T790M in patients received TKI monotherapy. EGFR mutation abundance decreased in patients received TKI combined chemotherapy, which supports better efficacy for a TKI combined chemotherapy as compared to TKI monotherapy. A good correlation between therapeutic efficacy and a change in circulating tumor DNA (ctDNA) status was found in 66% of patients, supporting the guiding role of ctDNA minimal residual disease (MRD) in NSCLC treatment.

conclusionEGFR-TKI monotherapy is applicable to EGFR-sensitive patients without concomitant alterations, while a TKI combined chemotherapy is applicable to EGFR-sensitive patients with concomitant alterations. CtDNA MRD may be a potential biomarker for predicting therapeutic efficacy.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsErbB ReceptorsHumansMutationPemetrexedProspective StudiesProtein Kinase InhibitorsEGFR protein, humanErbB ReceptorsPemetrexedProtein Kinase InhibitorsDynamic detectionEGFRMinimal residual diseaseNon–small cell lung carcinomaTyrosine kinase inhibitors

Identifiers

PMID36791768
PMCPMC10372607
OpenAlexW4320496632

What OpenQuestion holds

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Registered trials

None linked

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.