Universität zu Köln

Suleiman, Ahmed Abbas, Frechen, Sebastian, Scheffler, Matthias ORCID: 0000-0002-9031-1368, Zander, Thomas, Kahraman, Deniz, Kobe, Carsten, Wolf, JRgen, Nogova, Lucia and Fuhr, Uwe (2015). Modeling Tumor Dynamics and Overall Survival in Advanced Non-Small-Cell Lung Cancer Treated with Erlotinib. J. Thorac. Oncol., 10 (1). S. 84 - 93. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1556-1380

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Abstract

Introduction: Pharmacostatistical models can quantify different relationships and improve decision making in personalized medicine and drug development. Our objectives were to develop models describing non-small-cell lung cancer (NSCLC) dynamics during first-line treatment with erlotinib, and survival of the cohort. Methods: Data from patients with advanced NSCLC (n = 39) treated first-line with erlotinib (150 mg/day) were analyzed using nonlinear mixed effects modeling. Exposure-driven disease-drug models were built to describe tumor metabolic and proliferative dynamics evaluated by positron emission tomography (PET) using 2'-deoxy-2'-[F-18] fluoro-D-glucose (FDG) and 3'-[F-18] fluoro-3'-deoxy-L-thymidine (FLT), respectively, at baseline, weeks 1 and 6 after starting erlotinib treatment. A parametric time-to-event model was built to describe overall survival (OS). Demographics, histology, mutational, smoking, and baseline performance statuses were tested for their effects on models developed, in addition to tumor dynamics on survival. Results: An exponential relationship described progression, and a concentration-driven drug effect model described erlotinib effect. An activating epidermal growth factor receptor (EGFR) mutation increased the drug effect as assessed using FDG-PET by 2.19-fold (95% confidence interval [CI]: 1.35-4.44). An exponential distribution described the times-to-death distribution. Baseline FDG uptake (p=0.0005; hazard ratio [HR] = 1.26 for every unit increase, 95% CI: 1.13-1.42) and relative change in FDG uptake after 1 week of treatment (p=0.0073; HR=0.84 for every 10% drop, 95% CI: 0.71-0.91) were significant OS predictors irrespective of the EGFR mutational status. FLT-PET was statistically less significant than FDG-PET for OS prediction. Conclusion: Models describing tumor dynamics and survival of advanced NSCLC patients first-treated with erlotinib were developed. The impacts of different covariates were quantified.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Suleiman, Ahmed Abbas UNSPECIFIED UNSPECIFIED UNSPECIFIED Frechen, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Scheffler, Matthias UNSPECIFIED orcid.org/0000-0002-9031-1368 UNSPECIFIED Zander, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kahraman, Deniz UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobe, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wolf, JRgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Nogova, Lucia UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuhr, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-418006
DOI:	10.1097/JTO.0000000000000330
Journal or Publication Title:	J. Thorac. Oncol.
Volume:	10
Number:	1
Page Range:	S. 84 - 93
Date:	2015
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1556-1380
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language POSITRON-EMISSION-TOMOGRAPHY; PHASE-II; SOLID TUMORS; DRUG DEVELOPMENT; GEFITINIB; GROWTH; RECIST; SIZE; PET; OPPORTUNITIES Multiple languages Oncology; Respiratory System Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41800