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Cited by 20Lung Cancer Treatments and MutationsLung Cancer Diagnosis and TreatmentLung Cancer Research Studies

Concurrent use of aspirin with osimertinib is associated with improved survival in advanced EGFR-mutant non-small cell lung cancer

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Liu, Xiaoke, Hong, Lingzhi, Nilsson, Monique, Hubert, Shawna Marie, Wu, Shuhong, Rinsurongkawong, Waree, Lewis, Jeffery, Spelman, Amy +8 more·2020·Lung Cancer
DOI 10.1016/j.lungcan.2020.08.023PMC PMC7577964
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Abstract

Background Osimertinib is the treatment of choice for advanced EGFR-mutant non-small cell lung cancer (NSCLC). However, novel strategies to improve the duration of disease control are still urgently needed. Aspirin has been shown to decrease cancer incidence and improve outcomes in various malignancies. Therefore, we evaluated a cohort of patients who received osimertinib with or without concurrent use of aspirin to assess whether the addition of aspirin may lead to improved clinical outcomes.Methods MD Anderson Cancer Center GEMINI database was retrospectively queried for EGFR-mutant NSCLC patients who received osimertinib with or without concurrent use of aspirin for progression-free survival (PFS) and overall survival (OS).Results A total of 365 patients were identified including 77 which had concurrent use of aspirin. Patients in the aspirin-osimertinib group had significantly improved PFS (21.3 vs 11.6 months; HR, 0.52; 95 % CI, 0.38-0.70) and OS (Not reached vs 32.3 months; HR, 0.56; 95 % CI, 0.35-0.91) compared to osimertinib group. In subgroup analyses, the aspirin-associated PFS benefit was observed in patients with and without central nervous system (CNS) metastases, as well as in osimertinib first-line setting and in subsequent line setting. The median PFS in EGFR 19Del patients was longer than EGFR L858R patients with osimertinib, and when aspirin was added, the median PFS significantly improved in both groups regardless of lines of therapy. The benefit from aspirin was independent of age, gender, TP53 mutational status, or PD-L1 positivity.Conclusion Concurrent aspirin use with osimertinib in EGFR-mutant NSCLC patients was associated with improved survival, regardless of lines of therapy, CNS metastatic status, EGFR mutation type, age, gender, TP53, and PD-L1 status.

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  • EGFR mutations were determined from formalin-fixed paraffin-embedded tumours or digital-droplet PCR for blood samples by CLIA-certified methods.

    “EGFR mutations were determined from formalin-fixed paraffin-embedded tumours or digital-droplet PCR for blood samples by CLIA-certified methods as previously described18,37.”

    From Structure-based classification predicts drug response in EGFR-mutant NSCLC (2021) · cites this paper as [37]

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  1. [39]Mok TS, Wu YL, Ahn MJ, Garassino MC, Kim HR, Ramalingam SS, Shepherd FA, He Y, Akamatsu H, Theelen WS, Lee CK, Sebastian M, Templeton A, Mann H, Marotti M, Ghiorghiu S, Papadimitrakopoulou VA, Investigators A, Osimertinib or Platinum-Pemetrexed in EGFR T790M-Positive Lung Cancer, N Engl J Med 376(7) (2017) 629– 640. 27959700 PMC6762027
  2. [41]Reungwetwattana T, Nakagawa K, Cho BC, Cobo M, Cho EK, Bertolini A, Bohnet S, Zhou C, Lee KH, Nogami N, CNS response to osimertinib versus standard epidermal growth factor receptor tyrosine kinase inhibitors in patients with untreated EGFR-mutated advanced non-small-cell lung cancer, Journal of Clinical Oncology 36(33) (2018) 3290-+. 30153097

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Authors
Liu, X., Hong, L., Nilsson, M., Hubert, S. M., Wu, S., Rinsurongkawong, W., Lewis, J., Spelman, A., Roth, J., Swisher, S., He, Y., Jack Lee, J., Fang, B., Heymach, J. V., Zhang, J., & Le, X.
Affiliations
  • The University of Texas MD Anderson Cancer Center (US)
  • Army Medical University (CN)
Corresponding author
  • Zhang, Jianjun
  • Le, Xiuning
ORCID
Venue
Lung Cancer
Publisher
Elsevier BV
Published
2020-11
Volume
149
Pages
33-40
ISSN
0169-5002 (ISSN-L)
DOI
10.1016/j.lungcan.2020.08.023
PMC
PMC7577964
OpenAlex
W3084333151
Cited by
20
References
57
Citations by year
2025: 2 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 3
FWCI
1.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Lung Cancer (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • University of Texas MD Anderson Cancer Center
  • American Association for Cancer Research
  • Sheikh Khalifa Bin Zayed Al Nahyan Institute for Personalized Cancer Therapy
  • Conquer Cancer Foundation
  • China Scholarship Council
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
  • Health Sciences › Medicine › Oncology › Lung Cancer Research Studies
Keywords
aspirin, osimertinib, EGFR-mutant non-small cell lung cancer, progression-free survival, overall survival, central nervous system metastasis, EGFR 19del, L858R mutation, first-line therapy, second-line therapy, TP53 mutation, PD-L1 expression
MeSH terms
Acrylamides, Aniline Compounds, Aspirin, Carcinoma, Non-Small-Cell Lung, Humans, Indoles, Lung Neoplasms, Mutation, Pyrimidines, Retrospective Studies, Protein Kinase Inhibitors, ErbB Receptors

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