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Background: The combination of radiotherapy and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as erlotinib and gefitinib in patients with advanced or metastatic non-small cell lung cancer (NSCLC) has not been widely investigated. For afatinib, a new second generation irreversible pan-EGFR TKI, no clinical trials in this setting have as yet been performed.
Case Report: We report a patient with a pretreated metastatic NSCLC receiving afatinib in combination with concomitant palliative radiotherapy to the mediastinum and primary lung tumor. The treatment was feasible and well tolerated. The patient achieved a partial response in the irradiated tumor region and the metastatic sites.
Conclusion: The combination of afatinib and radiotherapy is promising and should be investigated further. However, because of the limited experience and potential side effects known for other EGFR TKIs, a decision for treatment outside a clinical trial has to be made very carefully, balancing the risk and benefit on an individual patient basis.
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http://dx.doi.org/10.1159/000362488 | DOI Listing |
Cancer Treat Res Commun
September 2025
Department of Oncology, Aarhus University Hospital (AUH), Palle Juul-Jensens Blvd. 99, 8200 Aarhus N (DK), Denmark.
Purpose: We investigated whether EML4-ALK fusions and mutations in pre-treatment plasma ctDNA predicted time to treatment discontinuation (TTD) in ALK-positive non-small cell lung cancer (ALK+ NSCLC) patients initiating first-line alectinib and evaluated clinical characteristics influencing TTD.
Materials & Methods: 42 patients from five Danish public oncology departments with previously untreated, metastatic ALK+ NSCLC were included in the study. All patients received alectinib, a second-generation ALK inhibitor, as their first-line treatment.
Clin Lung Cancer
July 2025
Fox Chase Cancer Center, Temple Health, Philadelphia, PA. Electronic address:
Objective: This study examined brain metastases among patients with metastatic non-small cell lung cancer (mNSCLC), characterizing prevalence, use of brain imaging, and treatment patterns.
Methods: Surveillance, Epidemiology, and End Results (SEER) data linked to Medicare claims were used to examine the prevalence of brain imaging at diagnosis among Medicare beneficiaries with mNSCLC (2015-2019, inclusive of follow-up). Predictors of receipt of brain imaging and first-line systemic treatment were evaluated using logistic regression models.
Thorax
September 2025
University College London, London, UK.
Curative-intent multimodality treatment-combining local treatments such as surgery or radiotherapy with systemic therapy-is the cornerstone of care in stage II-III non-small cell lung cancer (NSCLC). Since 2017, the systemic therapy backbones with multimodality treatment have undergone a dramatic transformation, driven by a series of pivotal, practice-changing clinical trials. Immunotherapy and targeted therapies, previously confined to the advanced/metastatic setting, are now firmly embedded in curative-intent regimens.
View Article and Find Full Text PDFESMO Open
September 2025
Department of Medical Oncology, Kanazawa University Hospital, Kanazawa, Japan. Electronic address:
Background: Resistance to alectinib, the standard first-line therapy for anaplastic lymphoma kinase (ALK)-rearranged non-small-cell lung cancer (NSCLC), remains a major clinical challenge. This study aimed to investigate resistance mechanisms using next-generation sequencing (NGS) of plasma cell-free DNA (cfDNA).
Materials And Methods: Plasma samples from 67 patients in the alectinib group of the J-ALEX study were collected at baseline, on day 57, and at treatment discontinuation.
Immunotherapy
September 2025
Department of Medical Oncology, Fortrea Inc., Durham, NC, USA.
Introduction: Pembrolizumab is a standard first-line therapy for advanced/metastatic non-small cell lung cancer (a/mNSCLC) lacking actionable mutations. Data from lower-middle-income countries (LMICs) remain scarce.
Methods: From January 2019 to June 2024, we prospectively analyzed 78 a/mNSCLC patients receiving pembrolizumab-based first-line therapy.