Treatment with Osimertinib-chemotherapy leads to significantly longer progression-free survival in EGFR-Mutated Advanced NSCLC

According to a recent study, first-line treatment with a combination of osimertinib-chemotherapy led to significantly longer progression-free survival among patients with epidermal growth factor receptor (EGFR)-mutated advanced non-small-cell lung cancer (NSCLC). This study’s results were published in The New England Journal of Medicine.

This phase 3, international, open-label trial included 557 patients with EGFR-mutated advanced NSCLC, who had previously not received treatment for advanced disease, in a 1:1 randomization ratio to receive 80 mg once daily of osimertinib with chemotherapy (500 mg per square meter of body-surface area of pemetrexed) along with either 75 mg per square meter of cisplatin or pharmacologically guided dose of carboplatin or to receive 80 mg once daily of osimertinib monotherapy. The primary end point of the study was progression-free survival as assessed by investigator. Along with this, safety and response were also analyzed.

At the end of the study, it was observed that progression-free survival was significantly longer in the osimertinib-chemotherapy group when compared to osimertinib monotherapy group. At 24 months, osimertinib-chemotherapy group and osimertinib group had 57% and 41% patients, respectively who were alive and progression-free. While 83% patients in the osimertinib-chemotherapy group showed an objective response, 76% patients in the osimertinib group showed the same response. The median response duration was 24.0 months and 15.3 months in both groups, respectively.

From the above results, it can be concluded that osimertinib-chemotherapy as a first-line treatment may lead to significantly longer progression-free survival among patients with EGFR-mutated advanced NSCLC.

Exercise-based rehabilitation programs improve exercise capacity in PE survivors with persistent dyspnea

A recent study found that exercise-based rehabilitation programs improve exercise capacity in patients with persistent dyspnea following pulmonary embolism (PE). This study was published in the Journal, Chest.

This randomized controlled trial included 211 patients with persistent dyspnea following PE diagnosis, without cardiopulmonary comorbidities who were randomized 1:1 to either the rehabilitation group (n=108) or control group (n=103). The rehabilitation group patients received two weekly sessions of physical exercise for 8 weeks and 1 educational session. The control group patients received routine care. The primary and secondary endpoints of the study were Incremental Shuttle Walk Tests (ISWT) between groups at follow-up and differences in the Endurance Shuttle Walk Test (ESWT), quality of life (EQ-5D and PE-QoL questionnaire), and dyspnea (Shortness of Breath questionnaire).

During follow-up, it was observed that participants allocated to the rehabilitation group performed better on the ISWT and had better scores on the PE-QoL questionnaire compared to the participants allocated to the control group.

Based on the above results, it can be concluded that patients with persistent dyspnea following PE, who underwent rehabilitation had a better exercise capacity during follow-up than those who received routine care.

Ciprofol is superior to Propofol in Painless Gastrointestinal Endoscopy

According to a recent study, appropriate doses of ciprofol outperformed propofol in terms of hemodynamics and respiratory stability during painless gastrointestinal endoscopy, with reduced injection pain, nausea, and vomiting. The findings of this study were published in the journal Drug Design, Development and Therapy.

This was a randomized clinical trial including 149 participants; 63 males and 86 females. The participants were divided into four groups: P-propofol 1.5mg/kg (n=44), C2-ciprofol 0.2mg/kg (n=38), C3-ciprofol 0.3mg/kg (n=36), and C4-ciprofol 0.4mg/kg (n=31). Time was recorded for the disappearance of the eyelash reflex, recovery time, gastrointestinal endoscopy time, and also the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score at awakening (T1), 15 minutes (T2) and 30 minutes (T3) post awakening.

Results revealed that the time taken to fall asleep with the three ciprofol groups was significantly shortened, with reduction in nausea and vomiting, when compared to Group P. Thus, ciprofol in varied doses outperformed propofol in hemodynamics and respiratory stability during painless gastrointestinal endoscopy.

Overall survival benefit seen with osimertinib in treating EGFR-mutated NSCLC

A recent study suggests that osimertinib has great overall survival benefit in patients having resected, epidermal growth factor receptor (EGFR)-mutated NSCLC (non-small-cell lung cancer) at stage IB to IIIA. The study’s findings were published in the New England journal of medicine.

The phase 3 study which was double-blinded, included 682 patients who were randomized in the ratio of 1:1 to receive either 80mg once a day of osimertinib (n=339) or placebo (n=343). The participants were to receive this treatment plan till there was disease recurrence seen, the 3-year trial regimen completion was reached, or a discontinuation criteria was met. Investigator-assessed-disease-free survival among patients with stage II to IIIA of the disease was the primary outcome of the study. The secondary end-point was disease-free survival, overall survival, and safety among patients with stage IB to IIIA disease.

It was seen that patients at stage II to IIIA of the disease showed an overall survival of 85% and 73% in the osimertinib and placebo groups, respectively. The patients who were at stage IB to IIIA showed a 5-year overall survival of 88% and 78% in the osimertinib and placebo group, respectively. From the above results, it may be concluded that adjuvant osimertinib increases overall survival benefit in those patients with completely resected, EGFR-mutated NSCLC at stage IB to IIIA.